Pathology is considered one of the oldest, yet most important pillars in medicine and healthcare. Over the past 20 years, technology has played a key role in disrupting and changing the landscape of several industries by digitizing traditional analog processes - and pathology is no exception. The term “digital pathology” emerged in the 1990s to denote these digitization efforts in pathology, however widespread adoption did not take place until the 2010s (1). Digital pathology focuses on scanner and storage technologies that allow pathologists to scan, view, analyze, integrate, automate, and share digital whole slide images.
In 2018, the digital pathology market was valued at $512 million USD. By 2026 it is projected to reach a value of $1.390 billion USD (2).
Digital pathology is set to experience massive growth over the next 5 years. Here are three major trends that are driving that adoption:
Decline in available pathologist
Aging demographics coupled with the higher incidence of cancer and disease worldwide has created a high demand and increased workload for pathologists. However, as the demand for pathologists continues to rise, the number of pathologists in the profession has started to decline. Pathologists have the second highest percentage of active practitioners aged 55 or older - and while many are beginning to retire; there are fewer new pathologists moving into the field to offset the shortfall (3). The number of seniors applying for pathology positions dropped by 27.5% between 2008 and 2017 (4). A substantial gap will develop, upwards of 30% of the available supply relative to estimated demand for pathologists' services by 2030 (3).
Pathology education is an area where digital pathology can play a vital role. Digital pathology tools like PathcoreScholar™ simulate the entire diagnostic journey and pathologist’s workflow, creating more engaging and enriching lessons. For instructors e-learning saves time, expands methodology, standardizes material, allows for evaluation of the entire diagnostic process, and streamlines assessment. Better training tools like Scholar help ensure that pathology students are well trained are ready to send out into the workforce. Digital pathology has also the ability to modernize and refresh traditional pathology education, which may perhaps encourage more medical students to explore pathology as a possible career route.
Amid the decline of pathologists, workload demands are also on the rise. The number of new cancer cases managed by pathologists rose by 41.73% in the U.S. between 2007 and 2017 (4). In contrast with physician specialties, “...a pathologist's workload is not capped by a specific number of patients [who can be seen and treated], but rather expands to encompass all case materials generated by their clinical colleagues” (4). This results in overwork, diminishing quality, and diagnostic variability. To address increasing workloads, many digital pathology tools are incorporating the use of artificial intelligence.
Using AI in digital pathology
Artificial intelligence is still in its infancy for clinical practice, but offers a potential solution to managing increased pathologists workloads, while at the same time delivering more-consistent and timely diagnostic care. It will ultimately enhance the ability of pathologists to review more cases and provide a more accurate diagnosis.
For patients, AI has the potential to reduce inter-observer variability and possible misdiagnosis. Diagnostic variability can lead to expensive and unnecessary courses of treatment that are not beneficial to the patient. These treatments come at a significant price to both patients and the healthcare system. It is estimated that in the US, 30% of annual healthcare spending (approximately $750 billion in 2016), is spent on unnecessary treatments and services (5). Digital pathology tools using AI can augment pathologists' decisions, provide a more complete and accurate analysis of tissue slides, and respond to illnesses in a more targeted, effective diagnosis and ultimately treatment.
Going fully digital
Digital transformation is disrupting every industry – and pathology is no exception. As labs begin to digitize their processes, the need for digital pathology tools and systems arises.
Digital pathology began with the introduction to WSI scanners and its ability to produce high-resolution images that replicate glass slides. WSI devices have become important tools that support diagnostic work and scientific discovery. But with the use of WSI comes the need for other digital tools that address data and image management, vendor-neutral archives (VNA), analysis, workflow and more.
Shifting to “fully digital” in pathology is not without its challenges, so what benefits does the implementation of a digital pathology system bring that makes the change worth it? Digitized workflows can increase productivity and reduce administrative errors, reduce turnaround time, and make possible remote consults and collaboration. These and other considerations can lead to major cost savings.¹ Ultimately, to make the transition to fully digital, pathologists need AI tools and a basket of algorithms that will effectively reduce their workload (time and effort per case) substantially within a streamlined, fully integrated digital environment. PathcoreFlow's™ open platform provides enterprise-grade data and workflow solutions — a prerequisite for AI adoption.
2020 promises to be a pivotal year for digital pathology as it continues to evolve and become more affordable and accessible than ever. Industry trends such as the decline of pathologists, the use of AI, and digital transformation are driving the adoption of digital pathology to address shortcomings within industry and take advantage of the benefits digitization brings.
¹ In a paper published on the National Center for Biotechnology Information (NCBI), a study analyzed how implementation of a digital pathology system can significantly cut costs. In a period of 5 years after implementing a digital pathology system, expected savings were estimated at $12.4 million dollars for a laboratory that had 219,000 accessions per year (6). For a large academic-based health care organization, there was approximately $18 million in savings upon fully implementing a digital pathology solution (6).