DIGITAL PATHOLOGY


Market Benelux


France DACH Italy


Nordics


Spain & Portugal UK & Eire


Expected Model of Cloud Adoption Hybrid / Public


Private (via local telecoms) Hybrid / Private Public Private


Private (via local telecoms) Public


Table 2: Cloud adoption and outlook across the healthcare environment.


While these products offer many of the benefits of cloud technology, there are also compromises in terms of technical scalability and elasticity for use in the cloud environment. Ultimately, these compromises will have impacts on integration, maintenance and cost of the overall deployment over time. Cloud-native products are software applications designed specifically for deployment in a cloud architecture – thus they are designed to leverage the inherent benefits of cloud technology (service-based architecture, microservices, containers, overall elasticity etc) and ultimately can offer performance and cost improvement over comparative cloud- enabled products if deployed in a cloud environment.


Cloud native products are much better positioned for general updates and AI deployments, so we advise caution when stakeholders begin selecting DP and LIS software.


Private vs public deployments In addition, although worldwide we expect cloud deployments to gain popularity, there will be some variation between public and private deployments, which have their own advantages as described in Table 1. Table 3 showcases which model we expect each western European market to prefer, often this is guided by national regulation. Sweden for example, has national regulation that prevents the use of public cloud offerings, but it does actively encourage private cloud initiatives. As previously stated, we expect the UK market will adopt a public cloud approach.


Future developments Worldwide, if each clinical pathology department adopted and stored digital pathology images, the total requirements for storage are estimated by vendors to be in the exabyte (1,000 PBs) range. But whilst the potential of digital pathology storage is impressive, it’s unlikely storage will be scaled without a significant reduction in costs. Providers currently have difficulty justifying the cost of scanner and software investments today and will soon have to contend with image


30 Product


Cloud Adoption Today (% of Contract Revenue)


Digital Pathology <10% Radiology IT


<25%


AI/ML in Imaging EMR PHM


40-50% 40-50% 70-80%


Cloud Penetration Outlook Short-Term


Low/Mid Low/Mid Mid


Strong Strong


Table 3: Expected adoption of cloud per market in western Europe.


analysis in addition to storage. There are vendors which are looking at tackling this problem through additional tiering and image compression techniques, but it is difficult to say when a solution will be reached. DICOMisation, which is being increasingly supported in both clinical and research environments, should also contribute to reducing costs for some customers through reducing average image sizes.


Many pathology departments are also exploring the possibility of capitalising on wider departmental budgets, by sharing existing VNAs to store their images. These are budgeted beyond the pathology department, although VNAs are still only likely to be a short- term solution. It’s also likely that digital pathology image storage for disaster recovery will be encompassed by wider organisational budgets.


‘Scan on demand’ is another method


being proposed by both providers and physical slide storage vendors which may work on the same merits as telepathology in terms of costs savings in slide transport. There is however a significant disadvantage that comes with these models today.


Image storage architecture is not just important from an individual or legislative standpoint, as cloud technologies are expected to support the adoption of AI by both scaling access to computational power (containerisation and use of microservices at a lower cost-basis) whilst also increasing the availability of DP images which can be used to train algorithms. Today organisations electing to delete images or pursue an ‘over-spill’ strategy are effectively losing out on the opportunity to contribute to a wider field of study.


DP image archives have a lot of potential in real-world data (RWD) studies as pathology images contain a wealth of new insights. Going a step further and combining DP images with other health modalities such as genomics or EHR data is currently being investigated by several academics and start ups with promising initial results. However, the nascent adoption of DP worldwide means that there is a lack of quality


training data for these algorithms, and aggregating enough data through prospective studies may take years. The NHS has unparalleled structure and scale as a healthcare institute. and as a contributor to these initiatives would be a powerhouse in driving personalised medicine forward. The UK government is showing more interest in engaging with these RWD studies for the betterment of the population through partnerships with companies like Plantir and Sensyne Health. However, without DP image storage, pathology departments will be unable to contribute significantly. Retaining data in large volumes, through easily accessible and structured formats is integral to achieving this successfully.


Increasing storage sizes In short, whilst IT challenges are felt by most departments within a hospital, in pathology these are only becoming more prominent. Despite this, storage vendors currently approaching customers directly have over the last five years noted a significant increase in average deal sizes for DP image storage globally. Where previously average storage deals ranged from 20-30 TBs per laboratory for proof-of- concept studies, today larger institutions are committing to up to 10 PBs of storage upfront. Worldwide the trend is clear, however it is now up to individuals to help drive this through to majority adoption and position departments well for the next era of digitalisation.


Imogen Fitt is a Senior Market Analyst at Signify Research.


Signify Research is a UK- based market intelligence firm focused exclusively on healthcare technology markets. Its coverage areas are Medical Imaging, Clinical Care, Digital Health, Diagnostic and Lifesciences and Healthcare IT. Imogen joined Signify Research in 2018 as part of the Healthcare IT team and is now focused on studying its diagnostic and life sciences sector, specialising in digital pathology.


Imogen.Fitt@signifyresearch.net www.signifyresearch.net/reports/ digital-pathology/


JUNE 2023 WWW.PATHOLOGYINPRACTICE.COM


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56