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The benefits and challenges of offsite working in Digital Pathology

In the fourth of this six-part series, the experts discussed the biggest drivers in the transition to going 100% digital. Here, the panel contemplated the potential cross-border solutions and challenges to the field, as well as the evidence for improved efficiency in digital pathology.

If you weren’t able to make the panel discussion, you can watch the recording here.

Peter Hamilton What do you think about the potential to use cross-border solutions for bringing more capacity into the UK market? How is your view from the college, for example, on that possibility?

Jo Martin In principle, it’s absolutely fine. One of the key things will be to make sure pathologists are qualified. Cross-recognition is already being done in imaging, so it’s recognition of qualifications, experience, and competence that is absolutely key. That’s what is going to underpin the network: recognition of qualifications from other nations, which we already do for many countries.

David Snead For any offsite working, it’s important that pathologists remain part of the team. That’s often a challenge if you’ve got pathologists who have never been in the department. It’s a challenge maintaining their contact with the rest of the group. Maintaining that while they are following updates to guidelines and improvements, as well as contributing to the rest of the team in terms of support can represent quite a challenge.

Having a regular face-to-face time with people who are working offsite is important, and I think it’s something that we’ve learned the hard way. We didn’t think that before we started to use some offsite pathologists, and it is now something that we’re very keen on because it’s surprising how even relatively minor things can cause quite a bit of confusion if not communicated well.

Peter Hamilton One other wave that’s going on in digital pathology is whether we can use this to promote our specialty. Should we open up the pathology packs to all the clinicians in the hospitals so they can see the slides in the same way they look at radiology? Perhaps for select groups like dermatology and renal physicians? Any thoughts?

Juan Retamero In our experience, having the flexibility to assign the right case to the right pathologist has created the right environment to foster such specialization. Digital pathology is the kind of tool that provides this kind of flexibility to subspecialize. Personally, if I were a hypothetical patient, I’d rather get my case seen by a specialist. Digital pathology actually enables that kind of possibility and flexibility.

Jo Martin As a pathologist, I can actually launch the radiology images on my desktop. I do occasionally look at the GI or the gut CT scans if I’m reporting a GI motility case. However, when you said that, I sort of shuddered internally about the clinicians having to look at the digital images. That’s probably related to the general paucity of histopath training throughout medicine. We all get a smattering of radiology training, but we don’t get much histopath training.

But in principle, I’m happy to let people have access to it, including patients. Patients like seeing their histology, and it’s often a very good way of getting them to appreciate what’s going on.

Peter Hamilton One of the problems with digital is the evidence of efficiency gains of up to 25 percent. Is there evidence? Do pathologists really report 20 percent more cases going digital? Pathologists’ contracts are not regular based. I wonder if that’s part of the barrier. What does the panel think about that?”

Juan Retamero In our experience, an increase in caseload is not part of your contract. You’re not going to get paid for any additional cases you do. But in our experience, we’ve calculated the number of cases per pathologist, and there’s definitely an increase of about 20-25 percent.

David Snead In our business case for our digital pathology system, we claim that we will get a 10 percent efficiency gain, and we certainly achieved that at consultant pathologist level. Whether that was purely around digitization is unclear because we did a number of other changes at the same time. But we certainly delivered a significant efficiency gain by going digital.

Take a look at the agenda for the upcoming Digital Pathology & AI Congress: USA. Alongside expert keynote speakers, the conference will comprise of a vibrant exhibition room full of technology providers showcasing their technologies and other solutions. 

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