The COVID-19 pandemic has forced health care institutions worldwide to consider the introduction of digital solutions. In this situation it is probably more important than ever to digitalize as many procedures as possible – including pathology.
Before even deciding on going digital, it can be difficult to know where to start. There are several digital pathology companies and solutions on the market; and pathology itself has many distinct branches with different needs. All this can be fairly overwhelming.
Going digital with your pathology laboratory requires preparation and a significant investment in both time and monetary resources. Preparation involves considering some key issues before embarking on your digital pathology journey – in order to help you make decisions that will have a positive impact on your institution immediately. Let us help you by spelling out some of the most important questions you need to ask yourself before going digital.
Question 1: What is your objective with going digital?
Key questions to ask:
- What exactly are you planning to digitalize?
- What type of slides do you work with?
This is the first and most important question. Do you want to use digital slides for high-volume routine diagnosis? Or do you plan to use digital pathology to help with teleconsultation? Or is it something very specific such as histopathological analysis of donor organs, hematopathology or cytopathology?
Each of these cases has different requirements for the systems to be purchased: high-volume routine diagnosis will necessitate a single high-speed, high-throughput scanner at a large central laboratory; however, other cases could require a small scanner at each site.
Make sure you spell out the specifics of your workflow for your supplier to challenge them to come up with the solution best tailored to your needs.
Question 2: Can your current IT environment accommodate digital pathology?
Key questions to ask:
- Is your current IT infrastructure able to handle the amount of data?
- Does your IT policy require digital slides to be stored locally?
Digital slides may be as large as a few gigabytes each; an average day at a large routine pathology laboratory can result in terabytes of data. If your IT policy mandates all digital slides to be stored locally, then going digital is likely to necessitate an upgrade of your storage infrastructure, which may cost you in excess of a hundred thousand euros or dollars.
And storage is not the end of the story. Your network should have the required bandwidth for quick scanning, transferring and viewing of slides; for best results, setting up a local network dedicated to your digital pathology laboratory should be considered.
Last but not least, advanced cybersecurity features are today more important than ever to protect access to your digital data, especially in routine pathology.
Involving IT early in the thinking will help you to better understand the technology implications of going digital and prevent IT-related issues at the later stages of the project.
Question 3: Where will the scanners be installed?
Key questions to ask:
- How many sites do you need to equip with digital pathology?
- Will you need one scanner or several scanners?
- What type of space will the scanner(s) need?
Your operating model will have a significant impact on the type of system you are considering adopting. Some cases (like hub-and-spoke laboratories) may require distributed installations at multiple sites, while in other cases (such as a single large laboratory or large-scale archival of slides) it may be more efficient to use a high-throughput scanner at a single location.
Finding the right place for your digital slide scanner will also require planning, as some devices may have a bigger footprint than others, some even demanding wide corridors and doors for easier moving during installation. Most vendors will also prescribe certain ambient conditions such as temperature, humidity, air pressure, etc. for storage and operation.
Question 4: How much time and effort will it take for a successful installation?
Key questions to ask:
- How fast can the selected digital pathology solution be set up, installed and operated?
- In case of a complex digital pathology solution supplied by multiple vendors, will everything work seamlessly?
Most devices require on-site installation and calibration by a skilled technician. With travel restrictions due to COVID-19 in effect, in-person hardware installations can take longer. Luckily, software installations may still be performed remotely.
Also, it often happens that the individual components (e.g. scanner, workflow software, image analysis software…) of a complex solution are supplied by multiple vendors. These may be all great individually, but can you be sure that they work seamlessly together? This is why it’s probably a good idea up front to consider a single vendor offering everything (scanner, storage, workflow software, viewer, image analysis) in an integrated package.
Question 5: What kind of training and support does the selected vendor provide?
Key questions to ask:
- What type (and level) of training and support does the supplier provide?
- How quickly can the supplier respond to service problems?
In-depth training and reliable support can greatly help the successful adoption of digital pathology. A reliable supplier makes sure that the devices and software are quickly integrated into your lab’s daily routine for an immediate positive impact. One way to make this happen is extensive in-person training for your staff, although you may have to do with remote training during pandemic closures. However, a well-designed solution should still be easy to use, even without training.
Importantly, ask your potential supplier about service response times. If a device requires a technician from a distance to be sent to your site to fix any service issue, your laboratory may be without a working scanner for days if something goes wrong.
Question 6: What does it cost?
Key question to ask:
- Do you take into account all the costs of going digital when deciding on your budget? (Not only the immediate cost of the scanner and related software but also additional costs of IT infrastructure, installation and support need to be considered.)
Nowadays, you can buy a digital slide scanner from 10,000 to several hundred thousand euros or dollars. The price alone, however, does not necessarily indicate what kind of pathology applications a device can handle, or how quickly it can be implemented at your laboratory.
Also, secondary costs such as IT infrastructure can considerably increase the total cost of the project and it is therefore essential that you take them into consideration up front.
Make sure you consult a reliable supplier to guide you through the process to ensure a successful implementation in the end. Why not talk to us? Feel free to reach out for a discussion.
