Adopting Digital Pathology: The Guide To Implementation

15 Minute Read                                                                            February 2, 2022

Summary:

In this guide, you will learn

  1. Easy steps to start adopting digital pathology
  2. Why reliability and product support affects your reputation
  3. The importance of having the vendor scan your slides
  4. Imaging solutions to fit your lab’s production volume and TAT per service
  5. Why you don’t need an LIS or LIS integration
  6. DP solutions don’t have to be expensive 
 
 It’s Okay To Start Small 

While there is much talk of going fully digital for primary diagnosis, doing a full digital rollout from the get-go can be a daunting change for the pathology department.  Many questions can be overwhelming:  How do I start?  How do I smoothly transition operations and staff to digital workflows?  How soon will the lab see the benefits of this huge investment?

It’s Smart To Start Small. Implementing one use case at a time lets your organization ease into digital pathology without overwhelming everyone with change. Start with one use case, or even just one scanner. Doing this will keep the changes small, allow you to validate incrementally, and see the benefits much faster. Here are some use cases that your lab can begin to implement:

Frozen Sections is an easy first use case to win over your staff.  Even a single scanner that has Live Viewing capability can offer immediate convenience and operational efficiency to your lab or hospital network.  From their office, pathologists view the slides streaming inside the scanner in the surgical suite.  They navigate the slides live to make a rapid assessment.  This is called live remote digital pathology.  Tell them that they can perform frozen sections without leaving their office chair and watch their faces light up.

Tumor boards or MDT meetings have also found exceptional benefits in going digital.  The strength is how the viewing software organizes annotations and presents the intended area of interest in sequence.  Typical viewing software will display each annotation centered at the zoom level that it was set, at the correct sequence across each slide in the case.  Presenting digitally, therefore, gives an impressive wow factor to the audience by simply clicking forward while describing the case, driving much faster than glass under a scope.  Start with one team member presenting digitally from their office on the next zoom call. Your team will soon agree that being tethered to a multiheaded microscope is a nuisance of the past.  

Similarly, your staff can smoothly take presenting at conferences and teaching to the next level—no more fumbling with PowerPoint presentations. The image viewer gives the impressive capability to zoom and navigate through a digital image while presenting versus being stuck with a static PowerPoint screenshot.  

Once your staff is comfortable with tumor boards, receiving and requesting second opinion cases is a similar and, therefore, an easy transition. Start small with scanning just a few difficult cases a week from a general pathologist and have the specialist assess them. The key here is to ensure the DP vendor offers an easy-to-use case management software designed for moving cases across pathologists and signing out reports.

Key Takeaway:  Start one use case at a time, progressing easy wins until your organization has fully captured all the benefits of digital pathology. 

Service and Reliability – Your reputation matters 

You ultimately deliver trust, so should your DP vendor.  If the scanner or software has issues, it will impact your workflow and your deliverables to the pathologists, and consequently the pathologist’s deliverables to the clinician. Ensure your DP vendor is on the same page: 24/7 technical support, onshore servicing, a good track record of reliability and guaranteed turnarounds are all good indicators that the vendor has your back.  We’ve all heard stories of how one hospital’s operations were impacted for over a month because the DP vendor did not have service staff in the USA (even though they sold them a service contract).  Another hospital called for help, but the Technical Support line was closed till the next day.

Key Takeaway: Choose a vendor that offers reliable customer support and has a track record of reliable scanners.  It’s risky to choose the new vendor that may not be around to support your operations.

It’s Okay to Ask Your Vendor to Scan Your Slides 

Many pathologists have told us that they had never had a chance to verify a scanner’s performance with actual case slides before purchase. Instead, the vendor used demo slides that didn’t quite relate to their tissue types or typical stains.  In some cases, suboptimal optics were used because the vendor did not know the samples would mainly be un-coverslipped. It scanned my one tissue well, but can it scan all my tissue types well?  If you have different tissue types, ensure the scanner has features to scan each well.

Before making a purchase, we recommend sending various slides to the vendor to scan. Doing this will give you the opportunity to evaluate if the actual image produced from your slides is of good diagnostic quality, yet without overkill. 

Key Takeaway: Although vendors will have most of the answers to your questions, it’s wise to confirm they can help by verifying that their image quality matches your needs. 

Make Sure the Vendor Knows Your Lab’s Production Volume and TAT Per Service 

Hospitals and pathology groups offer different services, have different caseload volumes, and committed turn-around times (TAT). For example, cytology and histology require different processes, prep times, and scanning capabilities. Your operations will likely need a combination of different slide capacity scanners as your adoption takes on more services.  A continuous loading scanner can be assigned to handle the larger daily volume of prominent cases.  Collect nonpriority cases for overnight scans.  Urgent cases that arrive sporadically during the day can be scanned in small batches on lower volume six-slide scanners.

Since slides are typically prepared the night before the pathologist receives their caseload in the morning, don’t let vendors convince you that you need to pay the high-cost for the fastest scanner.  The slides will be scanned overnight anyway and images will be waiting for hours until the pathologists arrive.  

What about QC?  Lab managers cringe when a pathologist calls to report a blurred image and has to request a rescan. The disruption to the workflow and TAT is significant when trying to locate the slide that has already moved forward from the imaging area.  Ensure your continuous loading scanner has quality control features so that it alerts the histotechnologists at the scanner station before the glass moves on.

Key Takeaway: Vendors have a lot of experience implementing various workflows, so ask for their advice on handling current volume and scaling as your volume increases.

You Can Benefit From Digital Pathology Without a LIS or LIS Integration

You don’t need a LIS integration or even a LIS to benefit from digital pathology.  Experienced DP vendors offer case management software that serves similar functionality to a LIS or can work side by side with your LIS at a fraction of the cost.  

A LIS integration is a significant project involving high-cost, long timelines, and consistent personnel resources across your organization, LIS vendor, and DP vendor.   

LIS integration ROI will only be worthwhile only once  high caseloads have been processed across a long period of time.

All automatically, the scanner will read the barcode from each slide, create the patient case, and parse the information into the case management software.  The Histotech or PA will just have to copy the few remaining fields into the case, but if you’re starting small, it’s better to get the benefits faster and for less investment.

Key Takeaway: Using the vendor’s case management software will implement DP much faster at a fraction of the investment of an LIS Integration.

Digital Pathology Doesn’t Need to Be Expensive

We asked our medical community what they perceive as THE biggest challenge of digital pathology adoption, and almost every pathologist and lab manager stated that the cost is the biggest barrier. They were hesitant to consider digital pathology due to the previous misconceptions that adoption is costly. 

In the early years of digital pathology, developing scanners required high R&D costs and therefore were expensive. Unfortunately, most vendors have maintained the high price tag even though manufacturing costs have come down significantly. 

Thanks to Motic’s thirty years in optics design and manufacturing and our business mission to make digital pathology accessible, we have long achieved a line of scanners that produce high-quality images, are reliable, and are innovative at less than half the cost.  Cost is particularly important when your hospital or pathology group wants to scale to service a larger region.  

Key Takeaway:  Choose a vendor that has experience in digital pathology for the long term so that you can trust that the product line will keep getting updated and your investment supported, and that the products are priced right (for your budget).

Play Video

Motic strives to make Digital Pathology accessible to every hospital and lab around the world. Watch our latest video featuring our Motic Expert, Nayan Banerjee, to learn how Motic continues to empower pathologists with the tools to change lives. 

You likely still have many questions or do not know what questions to ask. 

Schedule a 5-10 minute consultation with a Motic Expert today!

By The Motic Team

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