Pathology Update

Pathology Groups Should Plan to Use Digital Pathology

Growing interest in digital pathology systems, whole-slide imaging comes with risks and rewards

WHEN AN ANATOMIC PATHOLOGY GROUP CONSIDERS IMPLEMENTING digital pathology and whole-slide imaging (WSI) for primary diagnosis, it must identify and understand a range of challenges and opportunities.

“Every pathology group should start by considering how it will use the related technologies of a digital pathology (DP) system and whole-slide imaging,” said Liron Pantanowitz, MD, Vice Chair of Pathology Informatics at the University of Pittsburgh Medical Center. “This assessment needs to include an understanding of how these technologies can help pathologist improve clinical care and diagnostic accuracy and, at the same time, create opportunities that add value to the group’s client physicians.

Changes to Workflow

“Another factor is how workflows change in the histology lab and with individual pathologists when DP and WSI are implemented by the group,” he added. “Nearly all pathology subspecialties can benefit from a transition to digital, but often in different ways. It is also helpful to know that workflow efficiency is hard to prove in advance of actual implementation of a digital pathology system and whole-slide imaging.

“Your pathology group must look at the profile and practices of each user,” stated Pantanowitz. “For example, different users and different pathologists will have unique workflow requirements that need to be accommodated by the system. These assessments will help your group identify what it wants to accomplish with DP and WSI, and what resources will be required to implement them.”

Closed vs. Open Systems

Pantanowitz next took up the question of whether the digital pathology system, scanners, and associated software are “closed-box” products or based on open architecture. “DP technologies are new and evolving quickly,” he explained. “This means means algorithms and modules will evolve and there may be add-ons.

“Open-architecture systems and products give your pathology group the capability to work with new tools that come along, especially in fields such as computational pathology and artificial intelligence,” he added.

Going digital means that pathologists must also look beyond the simple function of image management. “Managing images is a basic function,” said Pantanowitz. “It is even more important to look at how your pathology group wants to manage its cases and its patients.

“This can only be done by asking vendors specific questions about how their products support such functions as case management,” he recommended. “Ask vendors to explain their experience in integrating their systems with your pathology group’s particular LIS.

“Further, don’t make the mistake of failing to anticipate future developments when choosing a system,” said Pantanowitz. “This is the time to ask prospective vendors how they plan to incorporate new features and new capabilities going forward.”

Pathology groups need to also acknowledge that the profession is moving away from simply reporting accurate test results within the accepted turnaround time. Instead, success will come from leveraging lab test data to create value for physicians, hospitals, payers, and patients.

“Laboratories are evolving into data companies,” observed Pantanowitz. “Digital pathology will be a foundational technology that enables pathologists to help physicians achieve faster, more accurate diagnoses, identify the best therapies for the patient, and better monitor the patient.

“As pathology groups assess the value DP and WSI can bring to their group, they need to similiarly identify the different ways that these technologies can help them contribute to improved patient care—and be paid for that value,” he added.

“It’s important that pathology leaders and practice administrators understand digital pathology is undergoing steady improvement in its performance,” said Pantanowitz. “For that reason, every pathology group should regularly assess how the current generation of digital pathology systems and whole-slide image has become more productive and cost-effective than earlier generations.”

Contact Liron Pantanowitz, MD, at 412-623-3746 or pantanowitzl@upmc.edu.

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