The digital pathology (DP) revolution has been brewing for some time. For decades, the healthcare industry has been marching forward with technology investments, starting with adopting electronic health records (EHRs) and, more recently, digitizing many other aspects of health as a business, such as patient communications, virtual appointments, cloud-based technology and more. In fact, according to a 2024 McKinsey survey of healthcare leaders, the vast majority—90 percent, to be exact—named “digital transformation” as a top priority for their organizations.
Now, the march towards digital is increasingly coming to pathology labs, fueled by several factors such as:
- The rise of cloud computing
- Advances in imaging equipment, resulting in high-throughput, FDA-approved scanners
- Growth in AI capabilities to support interpretation
- A deeper understanding of the role of quantitative pathology in disease characterization
- And more
To embrace this exciting future and get all the benefits of digital pathology, labs must make a number of digital pathology investments. From an infrastructural perspective, these investments include:
- Digital Pathology Scanners and Monitors: Whether they’re high throughput scanners or smaller format scanners that operate at lower scale, pathology laboratories need to have the right equipment in place to actually capture samples onto slides.
- Image Management Systems (IMS): These software programs allow pathologists to actually see the whole slide in digital format, and they’re typically integrated bidirectionally into both the lab’s scanners and laboratory information system (LIS). For example, our AISight IMS platform integrates and provides labs with a cloud-native, centralized hub for case and image management, all powered by AI tools.
- Storage Infrastructure: Because scanning slides creates very large files, pathology labs need to invest in excellent digital storage solutions. Some of this storage may be on-premise—meaning actual, physical servers that the organization owns and manages—or in the cloud—typically servers belonging to a cloud provider.
- Network Investments: If labs haven’t upgraded their internet service and infrastructure, they may need to invest in more bandwidth to process all the digital files and cloud software moving through the ether.
However, it’s important to remember that digital pathology investment means more than tech—it also means talent. Even with the rise of AI, each of the categories above requires people. From operating expensive scanners to helping organizations embrace change, digital pathology transformation requires the right talent.
Without the right people in place, tech investments will fail. That’s why in this blog post, we’re walking through four of the key areas of talent any pathology lab needs to successfully embrace and benefit from digital pathology.
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1. Scanning Staff
Scanners don’t operate themselves—even with advanced technology and algorithms, there has to be someone there to ensure proper operation. Pathology labs should consider hiring staff to support this new step in the pre-analytic workflow.
But just how many people does it take to do all this?
Large tertiary medical centers offer a helpful guideline. In a paper published in Journal of Pathology Informatics, the writers found that Memorial Sloan Kettering Cancer Center required around 1 full time employee (FTE) for every 3-4 scanning machines. By taking this formula, labs can figure an approximate headcount and cost, depending on how many scanners they purchase.
2. IT Support
Digital pathology investments in hardware and software create new workflows—and new IT questions. That’s why any organization moving towards digital pathology needs to take a look at existing IT resources, bandwidth, and expertise.
Most organizations will have some level of existing IT support, especially in larger medical centers, lab networks, and health systems. However, moving to a digital approach may require new FTEs, especially for more complex or large setups.
Organizations can start determining the level of IT support needed by asking a few questions:
- Who is offering workstation-level support?
- When there is an integration issue, who is responsible and/or capable of responding?
- What is the process for setting up new instruments, and who does the set up?
- How long do each of these tasks take to complete?
3. Change Management Staff
We’ve all heard the famous axiom that “culture eats strategy for breakfast.” And it’s true: organizations can spend millions on digital pathology investments—like elaborate software workflows and expensive machinery—but it’s all just wasted cash if no one actually uses it.
It’s important to remember that digital pathology represents a major change for most pathologists. It’s not always easy to shift a team from manual processes to a digital workflow. By nature, humans cling to what’s familiar: pathologists have been trained a certain way and done things a certain way for decades.
What’s more, they’re incredibly busy, so they’re unlikely to want to wait for glitchy software or struggle with tech they don’t understand. That’s true even when the many benefits of digital pathology—such as time savings, cost savings, greater efficiency, etc.—seem obvious to administrators.
Organizations should factor in the need for change management staff. These folks will get pathologists excited about digital pathology, ensure they can see—and want—the benefits that digital workflows offer, and become advocates for the shift away from manual labor. They will ensure each pathologist has the training and know-how necessary to successfully embrace digital transformation.
Additional Considerations for Investing in Digital Pathology
When it comes to a digital-forward lab, there are considerations beyond equipment and new staffing needs—your existing pathology team will need to contribute, too.
Labs are subject to numerous regulations and quality/safety standards, which means any new systems need to be rigorously validated as CAP/CLIA compliant. This means your existing pathology team will need to spend some time upfront on ensuring their new digital pathology setup is compliant.
In 2023, the team here at PathAI conducted interviews and uncovered insights into the amount of time pathologists spend setting up a new digital pathology system.
Those 30 hours are used to:
- Review and compare digitized slides vs. glass slides to ensure accuracy
- Conduct discordance analysis
- Complete required documentation
- And more.
While that may seem like a lot of time to ask pathologists to divert, it’s well worth the investment. Those 30 hours are merely a startup cost that will be amortized over years of digital productivity. And keep in mind the number of hours will vary based on the complexity of each organization—with more staff, the hourly workload for each pathologist will decrease.
Digital Pathology Investments Go Beyond Tech
Digital pathology may be newer, but it’s here to stay. While some estimates put the number of labs using digital pathology at 10 percent, we at PathAI believe the volume of cases going through digital workflows to be much higher, given many of the highest volume labs have previously—or are actively—implementing digital. Digital pathology is a competitive selling point for many labs working with big pharma, cutting-edge biotech innovators, and other players in the life sciences. Regardless of how many labs have already embraced a digital pathology journey, the trendline is moving up and to the right: we estimate that full-scale digitization of the US and European markets will be achieved in the next decade.
That means labs need to start thinking now about the future—and the digital pathology investments it will take to get there. And to succeed, labs need to make plans for not just costly, high-throughput lab equipment and state-of-the-art software, but also the right team to implement, maintain, and grow.
By starting to plan today, labs aren’t just investing in digital pathology—they’re investing in their people, their patients, and their future.
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