DIGITAL PATHOLOGY
Digital pathology worldwide: context, concerns and case studies
UK laboratories have received unprecedented funding for digital pathology in recent years, resulting in arguably the highest penetration of scanners in a public healthcare setting worldwide. Digitisation is not exclusively happening in the UK, however, and as other countries embark on their own digitalisation journeys, this article examines some pioneering implementations worldwide, ultimately asking what lessons can be learned.
The UK digital pathology (DP) market has been one of the most active worldwide in recent years – primarily due to an abundance of funding from the UK government. Commitment to digitisation was further renewed in January 2024 as the NHS announced it will support National Screening Committee (NSC) recommendations to allow the expanded use of digital pathology across the NHS for second opinions and off-site work. This will be designed to help support the diagnosis of breast, bowel and cervical cancers – and is a strong indication of further investment to come.
However, recent surges in DP adoption are not restricted to the UK market, as clinical settings globally are choosing now to invest in scanners and DP-related software. This has resulted in strong, sustained growth in the industry worldwide.
Most institutions are still relatively new to DP workflows, with the scope of implementations ranging from single- scanner sites to large networks with hundreds of units in continual use. Despite the existence of the latter, most laboratories are still in the earliest stages of implementation, and there are very
few reference sites globally that we can look to for case studies concerning high volume usage.
UK digital pathology The UK’s pathology departments have for some time been under strain, with a 2018 report by The Royal College of Pathologists indicating that only 3% of NHS histopathology departments have enough staff to meet clinical demand.1 This comes despite an increase in histopathology activity of 30% across the NHS since 2018/19.2
Thus, investment in pathology was welcomed with open arms when it was initially announced. At the time, healthcare IT and in particular laboratory information systems (LIS) were increasingly gravitating towards the formation of regional and national clusters, which it was hoped would simplify purchasing and help facilitate standardisation and better information exchange across the NHS.
Whilst pathology departments initially hoped to wait for national and regional LIS software to become a reality, progress in achieving this was far too slow and eventually trusts had to move forward with purchasing scanners or risk losing the funds allocated. Lessons learned have both
It’s estimated that more than 80% of NHS trusts currently have access to a scanner, but most of these have been purchased recently and scanning volumes still represent a very low proportion of total slides analysed.
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emphasised the difficulty in integrating DP with outdated on-premises LIS
APRIL 2024
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