The Future is Now: Digital Pathology is Pathology
In April 2021, the Digital Pathology Association (DPA), European Society of Digital and Integrative Pathology (ESDIP) and Japanese Society of Digital Pathology (JSDP) established a global task force with the intent of promoting worldwide adoption of digital pathology. This alliance aims to boost the exchange of knowledge across borders, unify concepts and standardization, and help break down political, social, and economic barriers, including things as basic as mistrust in digital pathology.1
Simply stated, digital pathology is the present. It's not the future anymore. As we and the other global task force members have noted2, the time to strike is now when the current technological and regulatory climate is favorable to support the digital transformation of pathology. Mature digital imaging technology exists to support a digital transformation in pathology, but transformation remains hindered by skepticism about the viability of adopting a digital workflow in routine clinical practice.1 Worldwide collaboration is needed to address the skepticism, to recognize we have commonalities – such as a shortage of pathologists and economic pressures – and to acknowledge important regional differences such as local regulatory requirements. We have a winning situation for everybody when we operate together to understand the difficulties in different countries, in different continents and to try to accelerate and remove some myths around digital pathology.
Recently, we participated in a webinar regarding digital transformation moderated by Colin White of Leica Biosystems and hosted by The Pathologist. We are encouraged by the strong response to the session, which attracted more than a thousand registrants, and the thoughtful questions from participants regarding how to start a journey to digital. The following principles emerged as foundational to digital transformation:
We must change the way pathologists think about the pathology lab and methodologies to address current and future demands, versus romanticizing how pathologists used to process samples. Education will be vital in this endeavor. In Japan, for example, Dr. Fukuoka’s fellows don't start with a microscope, so they don't need any special education in digital pathology. Experienced pathologists should be made aware of the tremendous progress that has been made to address historic challenges to digital pathology adoption. Many of the historic technology, cost and regulatory barriers have been overcome. We have cloud computing. We have infrastructure. We are seeing a reduction in the cost of digitizing per slide. But even with all these advancements, pathologists are still hesitant to adopt digital pathology.
To overcome pathologists’ hesitance, it is helpful to start the journey to digital sooner rather than waiting, and to start small. Our collective experience is to focus at the outset on building something good and demonstrating that it's going to solve a gap in current practice. People will use it and you can grow from there. At the start of implementation expect a few users, whose experience will resonate among and attract other pathologists to see digital pathology in action. From there, we’ve found adoption will exponentially grow.
Once a pathologist is presented with the perfect whole slide image, there is no way he/she will want to go back to the microscope. You’ll achieve a double goal: make pathologists happy and prepare yourself for AI. We’ve found that the usage of the whole slide images invites exploration of AI and predicts parallel growth. The potential of AI is exciting, and ushers in the possibility of working synergy with AI tools and having reports which have more quantified data. Ten years ago, we used to talk about the promise of AI. AI is not a promise anymore. It's a reality. The first AI app has FDA clearance in the United States. There are many more which are on the verge of being released. There is commercially available software that pathologists can use and there is also open-source software available. We’re shifting to an era where there will be no digital pathology or AI, it's all pathology.
We welcome pathologists and the broader pathology community worldwide to listen to the replay of the webinar and join future Global Task Force events.
- Eloy C, Bychkov A, Pantanowitz L, Fraggetta F, Bui MM, Fukuoka J, Zerbe N, Hassell L, Parwani A. DPA–ESDIP–JSDP task force for worldwide adoption of digital pathology. J Pathol Inform 2021;12:51.
- Griffin J, Treanor D. Digital pathology in clinical use: Where are we now and what is holding us back? Histopathology 2017;70:134-45.
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