Examining Digital Pathology�s Increasingly Important Role in Care
Pathology plays a central role in the process of disease detection, interpretation, and definitive diagnosis. In fact, most tissue-based diagnoses performed in the US today are rendered by a pathologist, through a process involving glass slide sample analyses performed using a microscope.
However, this traditional way of working comes with a downside; aside from the innate delays built into its processes, including the time and risk associated with the transferring of physical slides, pathology laboratories are among the last in medicine to benefit from digitized workflows.
As the healthcare industry continues to evolve and transition to value-based care, pathology will also evolve with the introduction of new imaging technologies to improve performance and automate the laboratory so as to deliver high-quality care and, ultimately, improve patient outcomes.
Why go digital?
Many of the recent innovations in healthcare, such as the increased use of telemedicine and smart devices to the growing capabilities in managing big data, can be traced back to the adoption of new technologies that fostered a different way of working. Innovation in pathology is no exception. With the introduction of digital pathology systems to aid in image-based analysis, the industry is beginning its migration from physical slide sample analysis to digital image analysis. While this transition isn’t an overnight process, the benefits are clear. Digital pathology addresses the limitations of traditional pathology workflows in the following ways:
Digitize workflows – Many of the day-to-day delays in traditional labs are logistical. Through digitization, labs can increase organization, streamline processes, increase caseloads and reduce turnaround time.
Connect teams – The multi-disciplinary care team is growing and increasingly needs enhanced collaboration capabilities. With pathology digitization, remote communication and collaboration across sites and specialties is further enabled.
Unify patient data – Cross functional integration and aggregated views of a patient clinical work-up support better informed decision making.
Gain new insights – Digitization enables the tracking and archiving of larger sets of clinical data. Through this, new insights can be uncovered and diagnostics can be advanced through access to a greater volume of expert knowledge.
In Europe, digital pathology systems have clearance for primary diagnostic use, which has led to increased adoption of the technology and measurable efficiencies within and across laboratories. Last year, Netherlands-based Laboratory for Pathology East Netherlands Foundation (LabPON), the largest pathology laboratory in the Netherlands, became the first clinical laboratory in the world to have transitioned completely its histopathology diagnostic procedures using Philips IntelliSite Pathology Solution instead of a microscope. Through an extensive and ongoing workflow comparison analysis, LabPON saw a significant increase in the speed of logistical workflow and increased throughput using digital diagnostics.
Justifying the transition
While some may consider digital pathology implementation as a complete “reinventing” of the discipline, my position on the transition to digital is that it is an opportunity for organizations that can lead to long-term growth and a positive return on investment, by for instance enabling pathology labs to offer consultation and second opinions to an every wider catchment area.
While the primary goal in the early introduction of digital pathology was to automate the microscope to allow pathologists to feel comfortable viewing a physical slide digitally – now, pathologists feel comfortable making diagnoses using digital images of the tissue versus physically looking at the glass slides. Given this transition already unfolding at the technology level, the role of the pathologist will only continue to change as the industry takes notice of the many benefits of a digitized system.
Unifying Patient Data
Pathology’s transition to digital can result in long-term organizational growth by leveraging one of the core facets of pathology – research and analysis. A great opportunity exists through pathology’s digitization with the creation of a comprehensive digital image repository containing the archived digital scans of glass tissue slides in massive volumes. Ultimately, these data will be made accessible to researchers. By integrating, analyzing and presenting the data available from whole slide pathology images, clinical laboratory services, pathology reports, radiology, and surgical and molecular pathology, unique insights can be obtained.
Creating vast amounts of ‘unlocked’ data, pathologists can view it within the context of other images, results and clinical information. The long-term benefits of a curated digital pathology image repository range from enabling improved clinical diagnostics to aiding in the development of future predictive analytics – ultimately helping to further personalize and improve patient care.
The road ahead
In the US, regulations surrounding the use of digital pathology whole slide imaging for primary diagnosis is beginning to shift, as recently confirmed through discussions between the Food and Drug Administration (FDA) and Digital Pathology Association which have the potential to streamline the regulatory clearance pathway for primary diagnostic use of the technology moving forward. This is a very positive sign for pathologists in the US who may soon benefit from digital processes throughout their routine work in the laboratory and within their care teams.
While nothing can replace the knowledge of the pathologist, unlocking and augmenting their knowledge through digitization is where the future of care can be impacted. As digital pathology becomes more sophisticated, more information about a specific tissue sample can be connected, catalogued and shared for a better understanding of a specific disease or patient population. As pathology continues its evolution and becomes more connected across the healthcare continuum, health systems and their multidisciplinary teams will also benefit from pathology’s increasingly important role in care, which has the potential to lead to better health management and more accurate, confident patient diagnoses.
General Manager, Philips Digital Pathology Solutions
Graduated in Biochemistry. Has a strong track record in deal making, acquisitions and the creation of strategic partnerships in the areas of life science, diagnostics, pharmaceuticals and consumer health. Has significant start up experience, but has also worked with multinationals and as a VC. Russ began in pharmaceutical research. Was founder of BIAcore (Proteomics) where he led commercial efforts and product development IPO’d in 1996. Founder of Orchid Bioscience, a pharmacogenomics/personalized medicine company IPO’d in 2000. Built up new venture businesses in Philips over the last 9 years. Currently works in the USA and the Netherlands.
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