Digital pathology

Digital pathology has the potential to improve patient care, and support the pathology workforce by making the diagnosis and monitoring of disease much more efficient. However, in order to transform pathology services, we need investment to support IT infrastructure, staffing and training.

THE IMPACT OF DIGITAL PATHOLOGY

Digital pathology:

• Benefits patients by enabling the rapid referral of cases between organisations or across pathology networks, enhancing access to expert advice and opinion on diagnoses
• Improves laboratory workflow and connectivity and increases flexibility and efficiency of the workforce, helping create digital training resources that support the development of specialists in training
• Increases our power to share slides and more, making it easier for others to benefit from the fantastic expertise in our profession
• Sets the scene for the use of artificial intelligence which will help bring advances to pathology services.

OUR WORK ON DIGITAL PATHOLOGY

The College fully supports the adoption of technologies that have the potential to improve patient care and support pathologists, though understanding that implementation will require investment. Only a handful of UK trusts are using digital pathology currently, and to grow digital pathology requires infrastructure including IT systems (an estimated figure of £2–4m for a large hospital), staffing and training a cohort of pathologists to be expert in digital pathology This is why we have developed a high-level strategy for the implementation of diagnostic digital pathology that provides a framework for considering the implications for diagnostic practice, training and assessment. 

Our strategy 

The College has agreed on a high-level strategy for the implementation of diagnostic digital pathology that provides the framework for considering the implications for diagnostic practice, training and assessment. This strategy outlines: 

• the perceived advantages and limitations of digital pathology in diagnosis
• the need for a coordinated approach to the use of digital pathology in training, examinations and service delivery
• a proposal for the national coordination of advice and guidance for those using, or intending to develop digital pathology.

The need for further research and evaluation of the technology is recognised. The work will initially relate to cellular pathology, cytopathology, veterinary pathology, paediatric and perinatal pathology and neuropathology. This does not preclude other specialist areas from taking this forward in the future.

Implementing digital pathology

College advice on the technical and practical aspects of implementing digital pathology have been developed by members of the Informatics Advisory Group and the Cellular Pathology SAC. Download the draft guidelines below. 

A general update from the Digital Pathology Lead, Dec 2021, including clarification on parts of the RCPath guidelines for digital pathology, and an update on the situation regarding using digital pathology during COVID-19.

The College Digital Pathology Committee have drawn up practical guidance on working remotely during the COVID-19 pandemic, bearing in mind that it may be necessary to use digital pathology to provide cover outside of normal circumstances.

The key messages are:

• Existing College guidance affirms that it is safe to use digital pathology with appropriate experience, risk assessment and risk reduction.
• Validation is a self-directed learning process by which pathologists learn how to diagnose digitally, based on comparison with the glass slides.
• Pathologists who have fully validated already will be confident in working remotely, possibly on lower specification equipment, and be very comfortable with assessing risk and making decisions digitally, sometimes in suboptimal conditions.
• Pathologists who have limited or no validation, or who have not used digital pathology before will find that they can confidently report some or many cases digitally, without undertaking a formal 1-2 month validation comparing glass and digital. but should be aware of the risks and mitigate these risks where possible.
• In exceptional circumstances they may decide to report cases digitally, using a risk mitigation approach – this does not remove the need for validation or quality assurance once normal services are being provided.

Darren Treanor, Digital Pathology Lead, on behalf of the Digital Pathology Committee of the College

AI in digital pathology

The RCPath has issued a position statement on the role of AI in cellular pathology. There is great potential for the development of AI to support the diagnostic process in pathology, especially image analysis in histopathology. Investment in digital pathology systems with joined-up IT systems and information sharing across organisations is vital to begin to understand the potential for AI-assisted diagnostics, and continued investment in digital pathology.

Also on the agenda