Going Digital, Turning Green

If the healthcare industry were a country, it would be the fifth largest polluter on Earth. Pathology professionals handle tens of thousands of samples each year to diagnose up to half a million diseases daily. But, as a specialty, pathology is particularly problematic for the environment due to vast amounts of transportation emissions.

The good news is that digital pathology can help reduce this waste. And the adoption of digital pathology has been steadily increasing. For example, a study conducted by the Journal of Pathology Informatics found that only 30 percent of participants reported utilizing digital pathology for primary diagnosis in 2013, compared to 53 percent in 2020.

Another survey conducted in 2021 by the College of American Pathologists revealed that approximately 64 percent of respondents used digital pathology for secondary consultation. This finding points to the collaborative advantage that digital platforms provide.

Even so, while digital pathology has become more prevalent over the past decade, for many labs and hospitals it remains one of the last analog medical sciences. In fact, a 2023 report by KLAS Research noted that digital pathology in the US is nascent, estimating that fewer than 10 percent of US organizations have adopted it for clinical use.

One key barrier to adoption is the lack of a clear strategy or blueprint for converting to digitization. This article explores the key steps to implementing a digital conversion strategy that ultimately ensures quality patient care and promotes a “greener” pathology practice.

Going digital
 

Numerous hospitals and labs have found that transitioning to digital enhances efficiency and improves patient care. Digitizing glass slides into high-resolution digital images transforms how pathologists engage with specimens.

Additionally, it means images can be electronically stored, eliminating the need for excessive physical storage. These images can be easily shared across the enterprise and with different institutions, facilitating remote consultations and promoting professional collaboration among multiple disciplines regardless of location.

As one research article puts it, “The benefits of digitizing pathology slides extend beyond mere convenience, encompassing efficient storage, seamless sharing, enhanced remote access, enriched education, and groundbreaking research opportunities.” All of which, ultimately, boosts the quality of patient care.

Simply stated, experts credit digital pathology with increased efficiency, workflow optimization, better traceability, decreased interobserver variability, and speedier diagnoses.

While patient care is the top priority, planet care is also critical. Positive environmental gains are another compelling reason to transition to digital pathology. Traditional pathology labs contribute to a substantial portion of carbon emissions due to their high energy demand, often using up to six times more energy per unit surface than a normal office building.

Conventional pathology processes generate large amounts of hazardous and solid waste, consuming vast amounts of water and ventilation, and generating chemical pollution that contributes to climate change. The most energy-demanding processes include couriers, which shuttle specimens from location-to-location throughout the day.

Digital pathology offers several environmental advantages. First, there is the reduction in glass, as one digital copy can replace numerous glass slides. That means less physical space is needed for storage, which translates to smaller lab facilities and therefore less energy use. With digital pathology practice, labs are well poised to reduce their carbon footprint. For example, there is far less use of chemicals such as formalin and xylene, as well as a myriad of chemicals required for special stains, which are harmful to the environment.

Healthcare organizations are accustomed to many quality standards. Ultimately, sustainability will prove to be a necessary element of quality policies. After all, healthcare professionals must not only care for patients, but also protect them. In the case of pathology, clinicians must ensure that the very pollutants the specialty causes do not harm patients. Transitioning to a digital practice is a critical step in that direction.

From analog to digital: key steps
 

Transitioning your practice to digital pathology requires careful planning as well as a significant investment of time and money. Here are some of the key steps you will need to develop a digital conversion strategy for your organization:

• Establish a governance body – Leadership must support the goal and the implementation plan. One way to get started is by establishing a committee that strives for ‘buy-in” from all stakeholders, including approval of the necessary investment to go digital. Typically, organizations need to present a financial business case for the conversion. Experts recommend that the business case should focus on the increased efficiency and reduced costs for the pathology department itself, as opposed to the broader gains of improved patient care throughout the organization, which can be harder to demonstrate. Your governance committee should also set both clinical goals (e.g., faster report turnaround times, more accurate diagnoses, etc.) and sustainability goals (e.g., reducing pathology’s carbon footprint by a specific percentage within the next three years).
• Communicate with collaborators – Keep other departments and referring physicians abreast of the goals, progress, and anticipated timing of your lab’s transition from analog to digital. Emphasize both the environmental and business/clinical benefits, such as a “greener” organization, faster access to previous studies, quicker slide reading, improved accuracy in patient–slide matching, and more efficient teleconsultations with partners.
• Choose the right technology – Pathology labs need extensive support in digitizing their platforms. It’s crucial to carefully vet several vendors, especially those with a proven track record in enterprise imaging for specialties like radiology and cardiology. The core competencies of Picture Archiving and Communication System and Vendor-Neutral Archive technology for these disciplines translate well for the pathology field. Seek a partner offering an end-to-end solution that can transform your lab into a fully centralized digital environment. A “scanner agnostic,” open platform solution is ideal to maintain flexibility in selecting the scanner technology that best meets your organization’s evolving needs.

A comprehensive digital pathology solution should include customizable dynamic worklists and streamlined case management. A robust solution will enable pathologists to view images, make diagnoses, and collaborate instantly from anywhere, accelerating report turnaround. It is also important to choose a secure, scalable solution to address data security and privacy concerns. Safeguarding digitized patient information from unauthorized access and breaches is paramount.

Standardization and interoperability are crucial in the transition to digital pathology. Lack of consistency can hinder effective collaboration, limiting remote consultations and the ability to gain multiple perspectives. The absence of uniformity in labeling and formatting emphasizes the necessity for comprehensive standards across the industry.

• Make training a top priority – Transitioning from conventional pathology to digital pathology represents a significant change in the way pathologists work. It’s critical for organizations to focus on educating their clinicians so that they are comfortable and proficient with new methods. Providing comprehensive training on digital tools and AI-driven insights should be a top priority. Pathologists need to fully understand AI recommendations and engage in critical evaluation to make well-informed clinical decisions.
• Track and share sustainability success – Develop a plan to monitor and report on short-term (monthly) and long-term (one year+) sustainability achievements. Focus on reduction, reuse and recycling efforts. Reductions can extend beyond the clinical area; for example, labs can minimize use of paper by adopting digital documents and digital publications, reduce energy consumption by turning off computers at the end of day; and so on. Reuse efforts might include turning traditionally single-use lab items into multi-use items. Recycling options can include solvents or even plastic gloves, as demonstrated by some labs.

Ultimately, reducing vehicle and airline carbon emissions when slides can be distributed and shared around the world digitally will be a great success story for digital pathology. Track your progress over time so it is quantifiable and available to all stakeholders. Finally, share your success story via your website, annual report, and other communication vehicles to build goodwill with referring physicians, your community, and patients.

A greener, cleaner future
 

Waste is an inevitable byproduct of healthcare, but it’s our collective responsibility to make sure we’re doing all we can to reduce the environmental impact of our industry – without sacrificing the quality of care. Transitioning from analog to digital pathology will empower your practice to better serve patients and the planet.

Experts predict that in the next 10 years digital pathology will be a requirement for pathology department accreditation and most departments will be fully digital, including cytology. Now is the time to implement a digital conversion strategy that ensures quality patient care and promotes a “greener” future for all.