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The biggest drivers for 100 percent adoption of digital pathology

In the third of this six-part series, the experts looked at issues surrounding the transition to digital pathology. Here, the panel considered the perceived hurdles involved in making this transition, and the possible benefits of digital pathology to patient safety.

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

Peter Hamilton What is the biggest hurdle to going 100 percent digital? Is it around the beliefs that pathologists have and the need to change their way of working? Is it by the cost? Is it by the lack of a business case? Are pathologists just too busy to think about it? Or is it that they can’t diagnose all slides with digital pathology?

David Snead I wonder if part of the reasoning behind it is the fear of trying to implement another major IT project in a pathology department. That does put people off because they recognize the limitations that they’re working under, often regarding the laboratory LIMS system that they’re using day in and day out.

From our point of view, that was a worry. We were very concerned about whether the IT infrastructure would be adequate to support full digitization. I have to say it’s managed very well. The interface was the major problem we experienced, but otherwise the deployment went through very smoothly for us.

Juan Retamero It’s also important to bear in mind that technology is now ripe whereas this was not the case perhaps 5 years ago. Technology is ripe, and there are a number of hospitals around the world proving that is the case, having gone 100 percent digital.

Neil Mesher If you look at the sites that have become digital – the sites that we are working with now through the Innovate program – one of the things those sites need to be able to demonstrate is that IT systems can cope now. Some of the other fees and some other barriers, we can start to knock those down, in fact, one by one as we go through. That needs to be a key deliverable of the Innovate program.

Peter Hamilton What is going to be the biggest driver of 100 percent adoption?

The biggest response from our local audience was around efficiencies and cost savings, followed by remote diagnosis and multisite collaboration. Interestingly, patient safety was not scored at all.

Juan Retamero I’m surprised that patient safety is not perceived to be an immediate benefit of digitization. I’m very confident that if I check in my suitcase, it is going to eventually reach the right destination at some point. I want the same thing to happen to my patient samples, and that’s thanks to technology. The integration of digital pathology with all the homework that you have to do in preparation in terms of tracking results in better patient safety. There’s no denying that. That’s probably going to be the main driver.

Neil Mesher We were all a little bit surprised that patient safety wasn’t scored at all. We’re used to ‘track and trace’: my children at home are ordering Christmas presents from Amazon like it’s going out of fashion and I know where the truck is from the minute it leaves the depot all the way through to it being delivered. If I can track and trace a parcel to my home and I can even find out there was nobody in so it was been sent somewhere else, but I can’t track and trace pathology, that would be staggering.

Peter Hamilton You seem less surprised, Jo?

Jo Martin Probably because this is not so overt. We did a big survey a little while ago, and we all know about where we’ve messed up, but we don’t know a lot about where other people messed up. One of the things that the college issued is a safety bulletin about is when you missed something either because somebody comes in and interrupts you, or because you skipped a slide.

Some of the particular benefits are difficult to quantify because we don’t report them, and when we report them they don’t always come out in a systematic safety way. But the more you think about patient safety in that context, the more we’ll realize that there will be safety benefits from this if we design the interfaces appropriately. There will be something about iterative design for those as well, or as we report problems and as we share problems, then the manufacturers and the providers will be able to solve some of those and make the systems even safer.

Juan Retamero Digital pathology improves patient safety in the preanalytical phase but also in the analytical phase because you actually are aware of which bits of the slide you’ve actually visited and which you haven’t. In theory, you flag out those areas that may be relevant that you just missed basically because you were interrupted. The improvement does not just pertain to the preanalytical phase, but also the analytical phase.

Jo Martin There’s also covert stuff. With one of my trainees, I was doing an audit of the compliance with the college dataset guidance. You go back to the files and some of them aren’t there. That’s a patient safety issue because we can’t improve, because we don’t know whether those were wrong or not.

David Snead is Consultant Histopathologist and Clinical Service Lead, Coventry and Warwickshire Pathology services, Jo Martin is President of the Royal College of Pathologists, Juan Retamero is Pathologist at Granada Hospital and Neil Mesher is CEO of Philips UK and Ireland. With thanks to Philips for sponsoring this discussion.

The agenda for the upcoming Digital Pathology & AI Congress: USA includes over 30 presentations from industry and academic leaders, 9 interactive roundtable discussions and more than 7 hours of networking time. Take a look at the agenda to see what else to expect.

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