Pathologists play a crucial part in patient treatment, particularly in cancer care. However, the field faces challenges such as resource shortages, workflow inefficiencies, and increasing complexity. To adapt, pathology departments are embracing digital solutions to enhance diagnostics and support the transformation of healthcare
The diligent work that pathologists do in labs every day significantly impacts patient treatment and care – particularly in cancer care, where pathology plays a crucial role in diagnostics and cancer staging. In fact, it’s estimated that 70% of important medical decisions affecting patients’ lives involve laboratory or pathology tests.*
Due to limited time and resources and the expectation to accomplish more at lower costs, pathology departments need to find new ways to adapt. As a result, pathology is beginning to transform into a digital discipline, bringing exciting new possibilities that can aid, streamline, and enhance diagnostic and clinical decision-making – so labs can continue to meet the highest standards and help drive healthcare transformation forward.
Benefits of digital pathology include:
- Unifying patient data in a streamlined workflow with bidirectional LIS (Laboratory Information System) integration, making use of an updated case viewer that enables multi- disciplinary patient data review and care pathway selection.
- Connecting teams with a scalable solution via easy sharing of patient- centric histology data across organizations with an open platform that enables new interoperability options to aid efficiency and maximize diagnostic confidence to improve patient care.
A case study: ASAN Medical Center
ASAN Medical Center (Seoul, South Korea) began implementing digital pathology in 2017. By 2022, pathologists there were using digital pathology for all surgical cases and consultation on cases from other hospitals and had converted ten years’ worth of analog slides to digital format. A 2,400-bed hospital that produces approximately 900,000 pathology slides yearly and diagnoses approximately 130,000 surgical pathology cases,
ASAN Medical Center, is a relevant case study for other healthcare organizations interested in how digital pathology can transform pathology workflow and efficiency.
Pathology Department Head Heounjeong Go, MD, PhD, highlighted reduced time to diagnosis, increased diagnostic confidence, and a better experience for pathologists and consulting physicians as the benefits of ASAN’s switch to digital pathology.
Digital pathology reduces time to diagnosis
Diagnosis time for histopathology cases at ASAN decreased by 19 hours and 51 minutes on average with digital pathology. In immunopathology, the diagnosis time decreased by one hour and 28 minutes. In the case of molecular pathology, when the method of specifying the region of interest was performed using the digital pathology system, the test time per case was reduced by about one hour.
A better experience for pathologists and consulting physicians
Dr Go said that pathologists prefer digital viewing with a microscope because of the ease of workflow and because the scanned images are able to be viewed at greater than 40x magnification, which helps identify small particles or organisms. The ease of sharing and discussing digital images improves collaboration with other clinicians.
Dr Go pointed out some of the past difficulties in diagnosing in the analog era: “If multiple doctors needed advice, they would all gather together and have a separate meeting, or they would come to the office one-by-one with slides and ask for opinions. Because these cases take significant time and effort, diagnosis can be delayed, and sometimes the diagnosis is made without sufficient consultation,” she said. “With a digital pathology system, you can easily consult multiple pathologists using a simple messenger app with screen sharing directly from the IMS and have those pathologists access and view your case at the same time, easily sharing opinions even if you are not in the same room. This is not limited to an opinion about the diagnosis but can also include additional tests that are needed, an interpretation of the tests, and the patient’s clinical situation. This allows for a more specific diagnosis that can be much more helpful in the patient’s treatment.”
The ASAN process: Realizing greater efficiency, aided by Artificial Intelligence (AI)
ASAN Medical Center changed the entire physical environment of the pathology department – including equipment, lighting, workspaces, and conference areas – to be conducive to a digital workflow.
The center stores its digital slides on-premise. EMR (Electronic Medical Record) and image management systems are tightly integrated for greater diagnostic efficiency, and integrated systems send all pathological ancillary test results from the pathology department to the digital pathology server. ASAN has implemented an interface for AI-based algorithms and is building a platform that can provide de-identified and pseudonymized diagnosis slides for research and external consultation. ASAN uses an AI-based program that takes less than one minute per case to evaluate the morphometric analysis; previously, a resident would spend two hours every day evaluating morphometry. In addition, reimbursement is greater for AI-assisted morphometry.
“I think AI will benefit productivity and diagnostic efficiency if we can use more models for a variety of purposes in addition to the morphometry we currently use,” Dr Go said. “For example, in the prostate screening model that is currently being used in multiple institutions, each of the 12 scores must be evaluated for diagnosis, Gleason score, Gleason pattern, tumor volume, total sample size and tumor portion size, number of tumor foci and neural tissue infiltration. This is laborious, cumbersome, and tedious. When describing a number of items, it’s easy to make mistakes. If the AI model does the screening first, and in particular, writes a report on the results, I think the accuracy and productivity of the diagnosis will increase dramatically.”
Beginning the transition to digital pathology
ASAN Medical Center’s experience provides one example of how an organization could implement a digital pathology system. Implementation will vary; however, organizations can begin by asking the following questions:
- Does a phased implementation or immediate conversion to fully digital make sense for the institution?
- How many years of analog slides should be digitized?
- What – if any – changes are required to integrate the EMR and the IMS?
- How will implementation change department workflow? What training will the staff require?
- How will the organization handle digital storage?
Partnering with a reliable digital pathology system provider can help determine the answers to these questions and make navigating the transition to digital technology easier. Dr Go said that throughout the process at ASAN Medical Center, Philips demonstrated that it is committed to quality, and the Phillips team works to innovate in digital pathology by truly listening to the pathologists’ feedback.
Philips is proud to serve as a partner before, during, and after digital transformation. Our teams have deep experience in workflow consultation, change management, training, and transition support – so you can rest assured that digitalizing your lab will be predictable and straightforward.
* Report of Second Phase of the Review of NHS Pathology Services in England, Lord Carter of Coles (2008)
Results are specific to the institution where they were obtained and may not reflect those achievable at other institutions.
The information presented represents the views of the institution and speaking physicians, not those of Philips.
This work is licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.
