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Major Drivers for the Conversion to Digital Pathology in Teaching Programs

Posted Oct 05 2009 10:02pm

I have just returned from the Pathology Visions conference in San Diego, which is now being converted from an Aperio user group conference to a vendor-neutral conference under the control of the Digital Pathology Association (DPA). This was one of the best managed and content-rich conferences that I have attended lately and I intend to post a number of notes about the ideas that the conference presentations have sparked in my mind. For today's note I want to concentrate on what I now consider to be the major driver for the adoption of digital pathology in the country's most prestigious pathology teaching programs.

Included in the Visions conference were lectures by Drs. Victor Reuter, Memorial Sloan-Kettering Cancer Center, John Pfeifer,Washington University School of Medicine, and Walter Henricks, Cleveland Clinic, about the merits of digital pathology in routine surgical pathology operations. Their PowerPoint lectures will be posted on the conference site in about a week and I will link to them as soon as they are available. I must confess that up to the time of this conference, I was unsure about the speed of the digital pathology adoption curve. I have been stewing about issues such as capital system costs, ergonomics, and "cultural resistance" to change in the departments. Given the obvious enthusiasm of these speakers, I have now changed my thinking about this topic.

If there is one thing that is important to the directors of pathology training programs, it is the quality of the trainees who apply for positions in their departments. Residency applicants, in turn, choose programs that will prepare them for their future careers by being staffed by well-known faculty and serving patient populations with challenging diseases. Part of this picture involves the opportunity to train using modern technology, which was hardly a consideration in surgical pathology until the introduction of digital pathology. Think of medical students applying for residency positions in radiology -- they seek training in the most current imaging technologies to give them an edge when they join radiology groups post-residency.

As soon as the surgical pathology program directors begin to obtain feedback from residency and fellow applicants that they will only apply to programs offering experience in digital pathology, most academic programs will quickly purchase and deploy the necessary equipment and learn how to use it in routine operations. I am told this is happening now. Meanwhile, the pathology departments in the 300-500 bed non-teaching hospitals will be forced to follow suit because their potential pathology hires will only seek positions in pathology groups providing such technology.

As soon as a teaching department convert to digital with the deployment of, say, pathologist dashboards/consoles and whole slide imaging (see: Horizon Anatomic Pathology Offers an Integrated Pathologist Dashboard ), the pathologists using this equipment will soon refuse to work with a mixture of digital images and glass slides. I predict that they will prefer to use one or the other and not a mixture of technologies.

Based on these ideas, I think that most of the academic pathology surgical pathology programs will have converted primarily to digital pathology in about three years and most of the 500-bed non-teaching hospital programs in the following three years or so. While this process is taking place, the digital pathology vendors will be improving the user-interface of digital pathology processes such that its speed and efficiency will approach that of the current manual process.

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