The nuances of digital pathology integration and interoperability

By Philips Featuring Imogen Fitt, Research manager, Signify Research, Cranfield, Beds, UK ∙ Oct 18, 2024 ∙ 3 min

Health informatics

Diagnostic and clinical informatics

Pathology

White paper

Pathology is just embarking on its digitization journey and there are multiple ways that departments can advance interoperability in partnership with industry. Standardizing whole slide image formats and promoting tight integration between different software systems will benefit not just individual users but also healthcare systems. Read this white paper to learn how interoperability can improve both pathologist workflow and the standard of care.

White paper

The nuances of digital pathology integration and interoperability

This whitepaper focuses on

  • How institutions at different stages in the digital journey must invest in infrastructure that supports the ability to access, exchange, integrate and cooperatively use data
  • How interoperability eases access to a patient’s complete case history, facilitates multidisciplinary collaboration, reduces manual tasks and delivers data for large-scale analytics
  • Ways to successfully use digital pathology using seamless, bi-directional integration between the laboratory information system (LIS) and the IMS

Pathologist looking at screen

Interoperability benefits

Adopting high level interoperability is a complex process. However, the many benefits of full integration make it a worthwhile investment. These include:

 

  • Easy access to patient data enables clinicians to more easily understand a patient’s complete case history. This both increases productivity and decreases duplicate testing
  • The ability to access data from multiple systems allows expertise to be pooled for better patient care. For example, multidisciplinary tumor boards (MDTBs) benefit when all board members have access to the same information and can share results and discuss treatment in real time
  • Sharing data across networks – or even outside of networks – facilitates second opinions and consulting
  • Large-scale analytics, can support patient care by enabling assessment of clinical and logistical data, including patient outcomes.
  • A harmonized common interface and auto-population of reports reduces manual tasks, enhances workflow and improves patient care as physicians spend less time looking for information and more time focused on patients.*

 

Digital pathology challenges

Digital pathology workflow presents some unique challenges, including:

 

  • Lack of existing infrastructure to support image acquisition, processing, review, storage and analysis
  • Large file sizes
  • Small budgets
  • Multiple proprietary image standards: Pathology has a plethora of proprietary image standards in use which make image exchange much more difficult, although the industry is now moving towards open exchange
  • Digital pathology requires the deep integration of LIS and imaging workflows to prevent duplication of labor, including order entry, result reporting, image storing, image manipulation and image management

Advancing DICOM for digital pathology

Digital Imaging and Communications in Medicine® (DICOM) is an established imaging standard that permits the sharing and storage of medical imaging and related data. Use of the DICOM standard for digital pathology enables easier incorporation into radiology PACS and VNAs, supporting cross-modality collaboration. Because it allows an organization to leverage existing investments in radiology archive solution by sharing with pathology, it also saves on investment in IT infrastructure. In addition, it has the potential to facilitate image analysis for research.

Preparing for a digital future

Efforts are underway to adapt DICOM for pathology applications. Rather than waiting for full development, pathology departments can invest in vendor-neutral practices to integrate across departments. An essential step is ensuring that non-imaging data can be exchanged bi-directionally between the LIS and the digital pathology image management system (IMS). The benefits of bi-directional integration are:

 

  • LIS software can register expected stains to occur, meaning that additional actions, such as extra cuts for molecular biology and immunofluorescent stains can be excluded
  • LIS software’s communication alerts the IMS when a case is complete and can be dispatched
  • Users can choose to report from either the LIS or the IMS
  • Access control allows the pathologist to have direct insight into what colleagues must report

Is now the right time?

Focusing on interoperability from the beginning allows start-ups to focus more on technological development in fields like machine learning and less on ensuring their technology is accessible to a wide enough audience. Beyond AI tools, throughout the healthcare ecosystem technologies such as digital companion diagnostics and federated learning are expected to impact clinical care in the near-term, becoming a necessity for most care providers. 

 

There are pros and cons to enacting a digital pathology strategy today. To mitigate risk, organizations should determine long-term strategy up front, seek clarity about integration from partners and investigate operational expenditure models, SaaS-based models or leasing contracts.

Conclusion

Interoperability facilitates key trends in healthcare, such as precision medicine, improving patient access to data, facilitating patient engagement outside of healthcare environments and enabling the management of finite healthcare resources.

 

Investing in interoperability today will enable both individuals and institutions to benefit from easier workflows and improved access to patient data, while simultaneously providing the opportunity to push multi-disciplinary care forward. Download the white paper.

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*Garcia CL, Abreu LC, Ramos JLS, Castro CFD, Smiderle FRN, Santos JAD, Bezerra IMP. Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. Medicina (Kaunas). 2019 Aug 30;55(9):553. doi: 10.3390/medicina55090553. PMID: 31480365; PMCID: PMC6780563

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