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dvances in digital-pathology systems, including rapid slide creation, data management, and image-visualization techniques are transforming the practice of pathology. A powerful tool in anatomic pathology, advancements in digital pathology continue to enhance efficiency and accuracy, resulting in lower costs, significant workflow efficiencies, and improved patient care.
Digital slides are a complete representation of the entire glass slide, viewable on a computer monitor at any magnification. Web-based pathology picture archiving and communication system, familiarly known as PACS, allow pathologists to work remotely anytime, anywhere, to deliver accurate results faster than traditional methods.
As digital pathology becomes more accessible for the average lab, the ability to work digitally provides opportunities to offer new services and tests, attract new customers, and create new business lines. Implementing an outreach business enabled by digital pathology is an emerging strategy that is helping many labs maintain market share and increase growth and profitability.
Gaining a competitive edge
Labs are continually challenged to provide fast turnaround time, technology innovation, and good service to deliver the best value, and, in many cases, compete for business. Patients and physicians rely on lab results to make critical healthcare decisions, and test results must be completed and reported quickly and accurately. Labs looking to meet and improve their level of service are increasingly turning to digital pathology.
In large healthcare systems, rural hospitals, and geographically distributed pathology labs, access to specialty pathologists for secondary consults can be very limited, requiring days for the transport of glass slides or to schedule a pathologist visit. With digital pathology, hospitals can leverage remote viewing capabilities by making entire slide digital images of specimens, such as frozen section or blood smears, available over a secure Internet connection for immediate review by an off-site pathologist. Pathologists can work from their homes or a facility hundreds of miles away to provide secondary consults or support the clinical needs of distant hospitals.
For pathology labs wanting to maintain and grow their outreach business, digital pathology provides a competitive advantage by providing access to the right pathologists, facilitating faster turnaround times, improved patient outcomes, lower costs, and increased physician satisfaction.
The flexible adoption of digital-pathology systems allows labs of all types to use the technology in niche applications and later expand the utility of the system to offer outreach services (e.g., slide scanning or secondary consultations) to hospitals in the community, or anywhere in the world.
The value of digital pathology is being realized in many different lab applications. Large reference labs are using digital-pathology systems to scan slides, making them easily accessible via the Internet by their own pathologists for timely interpretation and reporting. Physicians in certain specialties (e.g., oncology) are requesting access to slide images to show their patients specific areas of interest. Toward this end, the adoption of digital pathology, which enables the rapid and efficient management of digital-slide images and supporting case information, is making these uses possible.
Telepathology
Telepathology offers many new opportunities for pathology. Small rural hospitals without access to pathology expertise benefit by having access to a virtual pathologist, and pathology labs can expand their lab’s reach by offering service coverage to a very broad geographic region. Digital pathology makes it possible to solidify and enhance a lab’s position in the community by being able to provide the same level of pathology expertise found in any major city, lending credibility and confidence in the diagnosis and treatment process.
More than 30 pathologists at the University of California-Los Angeles (UCLA) are currently using digital pathology to market their sub-specialty expertise and provide real-time pathology consultations to the Second Affiliated Hospital in Zhejiang Province, China, toward helping the country achieve its goal of medical reform. Patients with complex cases or special requests can have their pathological images scanned and reviewed by UCLA for diagnosis; remote teleconferences can be conducted between colleagues around the world to review challenging cases.
A lab group in Bellingham, WA, is providing a new telepathology service to access and view slides in Ketchikan, AK, allowing surgeons in the operating room at Ketchikan General Hospital (KGH) real-time consultation with pathologists in Bellingham. The pathologist can change focus, magnification, and field of view with an online interface to review a frozen tissue slide prepared in Ketchikan.
KGH is among the first wave of hospitals in North America to use telepathology in an intraoperative setting. Digital pathology is especially beneficial to smaller, rural, critical-access hospitals where technical experts may not be readily available. Benefits from using the technology are improving cost, travel, time, efficiency, and slide-management issues to help improve patient care.
Going digital
As use of digital pathology becomes more widespread, labs of all sizes will see a host of workflow and cost benefits, as well as the ability to expand their reach to provide the best level of service and quality care.
Jared Schwartz, MD, PhD, brings 30 years of pathology expertise to his role as chief medical officer of Aperio, and most recently served as president of the College of American Pathologists, and director of Pathology and Laboratory Medicine at Presbyterian Healthcare in Charlotte, NC.
