Clinical Scorecard: Scanning New Horizons (in Digital Pathology)

At a Glance

Key Highlights

• Nationwide Children’s Hospital has implemented prospective digital scanning for primary diagnosis since 2024 despite limited LIMS integration.
• Digital pathology enables remote collaboration, case review, tumor boards, and global research data sharing in pediatric pathology.
• Staffing, informatics integration, and contingency planning remain key challenges in digital pathology adoption.

Guideline-Based Recommendations

Diagnosis

• Use digital pathology scanning to complement traditional glass slide review in pediatric pathology.
• Implement hybrid models scanning all slides first to provide digital access while maintaining glass slide availability.

Management

• Cross-train laboratory staff to cover scanning and digital pathology operations due to limited staffing.
• Plan contingencies for scanner failures, network outages, and software issues to ensure operational continuity.

Monitoring & Follow-up

• Validate digital scanners for primary diagnosis before clinical implementation.
• Monitor turnaround times to ensure digital pathology adoption does not negatively impact patient care.

Risks

• Potential delays or errors if digital pathology systems are not fully integrated with laboratory information management systems.
• Operational risks from hardware/software failures and limited informatics support.

Patient & Prescribing Data

Pediatric patients undergoing pathology evaluation

Digital pathology facilitates timely diagnosis and supports molecular profiling initiatives critical for pediatric oncology care.

Clinical Best Practices

• Adopt a hybrid digital pathology workflow to balance digital access with traditional slide review.
• Invest in staff training across clinical and informatics domains to support digital pathology operations.
• Engage in prospective validation and continuous quality monitoring of digital pathology systems.
• Leverage digital pathology to expand access to specialized pediatric pathology expertise remotely.

References

• Nationwide Children’s Hospital Digital Pathology Program
• The Cancer Genome Atlas
• Children’s Oncology Group Molecular Characterization Initiative