While digital pathology and AI might be the talk of the (laboratory) town, only a minority are actually working with it. This represents a huge growth potential for the digital pathology market.

But all this exciting possibility might leave lab leaders scratching their heads. In such a young and emerging market, where can they find hard facts on product reliability, customer satisfaction, and comparative performance?

That's where KLAS comes in. The US-based health sector tech research organization is striving to fill exactly those knowledge gaps. It recently published Digital Pathology 2026: Early Adoption & Technology Performance in an Emerging US Market (available from https://klasresearch.com/reports). Focusing on image management systems, digital slide scanners, and AI algorithms, the report shares independent benchmarking data on the major vendors in the US market – giving that all-important side-by-side comparison of competing companies and their products.

A market full of promise – and uncertainty

Of the estimated 15 percent of US healthcare providers that have adopted digital pathology, most are merely scratching the surface of its potential, according to Eder Lageman – VP of Engagement at KLAS, and senior author of the 2026 digital pathology report. “Most labs do only a small percentage of their histology work digitally,” he explains, “and in cytology it’s almost zero.”

As such, it can be difficult to assess the return on investment of a digital switch. “Only those organizations who are doing almost everything digital, at least in histology, get a lot more outcomes for their investment,” comments Lageman.

While some European countries – such as France, Sweden, the Netherlands, the UK, and Spain – cite more than 50 percent digital adoption, it’s fair to say that pathology is still in the early days of the adoption curve, particularly in the US.

Over the last decade, a few vendors have emerged as leaders of this growth market. However, there is very little comparative analysis of the companies and their kit available to lab leaders. That creates a credibility gap between vendor claims and real-world performance. Then, when you throw in compatibility issues with legacy laboratory information systems (LIMs), procurement decisions can be daunting.

A basic introduction

Now, with a 30-year history in benchmarking healthcare IT, KLAS has stepped up to provide a response to this uncertainty in digital pathology.

Drawing on its research experience in technology in more than 100 healthcare sectors, KLAS produced its first digital pathology report in 2019.

“It was right before the pandemic,” recalls Lageman. “I think it was perfect timing because lockdowns were a catalyst for adoption of digital pathology to increase. We published a basic report highlighting the essentials to get started: slide scanner, image management system (IMS), high-resolution monitor, and file storage.”

The report has expanded each year since then and, in 2026, it included a dedicated section on AI algorithms for digital pathology.

An independent intermediary

The goal of KLAS reports is to help healthcare providers make informed decisions on technology purchases. By collecting feedback directly from the users of digital pathology, KLAS is able to benchmark vendors against each other and provide comparative ratings.

Lageman explains the research methodology: “We don't do our own evaluations – healthcare is not our specialty. Instead, we interview end users and ask them to rate and evaluate the solutions they're using against a list of criteria.”

The ten-question interview framework employed by KLAS offers robust, standardized evaluations. Going beyond technology performance alone, the KLAS investigations also probe the supplier-client partnership.

This approach not only gives KLAS credibility as an independent evaluator, but also positions their insights to cut through vendor marketing claims. Its reports open up purchasing decisions that are grounded in peer experience.

Adoption realities

The other advantage of user-generated insights is in highlighting some of the real-world barriers to digital adoption.

“It requires a lot of change management to adopt digital pathology,” reflects Lageman. “Some pathologists – particularly those nearing retirement – are not ready for change. They tell us they want to retire with their microscopes still in their hands, and let the next generation handle the digital transformation.”

Workflow changes can also be daunting for some institutions. And KLAS research has unearthed some alarming stories in this regard.

“We have seen organizations sign with a supplier and implement a digital workflow, just to see pathologists to refuse to use it because it was taking longer than the old analog workflow,” says Lageman. “Adoption is not just a technology problem; it’s a people, workflow, and infrastructure problem.”

Helping labs over the hill

For first-time adopters, the KLAS digital pathology 2026 report can act as a handy navigation tool. With its focus on the most fundamental components of digital workflows – IMS, scanners, storage, and AI tools – it can serve as a handy reference to kick-start those very first conversations with vendors.

“A lot of labs entering on this path don’t know how to handle data storage,” says Lageman. “Digital pathology requires huge image files – bigger than most radiology images. So, data storage and management needs to be a consideration from the outset. Our report helps labs to think about the issues to consider when they start adopting the technology.”

KLAS reports compare named vendors in terms of market share, performance, and customer perceptions. With this approach, KLAS frames vendor comparisons around real-world usability and support, not just product features.

“Our independent research structure allows digital pathology users to be honest about any frustrations with their suppliers,” says Lageman. “Conversely, if they have a great partner, they can tell us what makes them great. Maybe the technology is user-friendly, it improves the workflow, the customer service is responsive, the tech support is generous, and so on.”

The level of ongoing support from a vendor can mark the difference between success and failure of a digital implementation, according to Lageman. “In some cases, suppliers simply deliver the technology solution and run,” he says. “Others continue the relationship after delivery, offering training and ongoing support. They really want the users to succeed with the technology.”

In this way, KLAS reports help labs avoid the mistakes of their peers: buying immature solutions, choosing poor partners, or underestimating implementation challenges.

The feedback loop

Along with technology gaps, KLAS reports also highlight competitor strengths and weaknesses, and, perhaps most importantly, what customers value. It is not surprising, then, that the reports – along with the annual “First in KLAS” awards, are followed as closely by the technology manufacturers as the customers.

“Our second goal is to help the suppliers to understand what the market still needs from them, and what their customers are complaining about,” says Lageman. “We offer a lot of sessions where we share insights with the suppliers, so they can understand what else they need to do to help clients to be successful.”

Monique Rasband – Global Vice President, Strategy and Research, Imaging and Oncology, at KLAS – is keen to acknowledge the legacy of this feedback loop in advancing the technology. “When the suppliers make changes based on this analysis, it’s incredibly expensive, both in time and resources,” she says. “So when they do tweak their tech or their customer service, we want to validate quickly whether the changes are positive and effective for the customers, and feed that data back as well.”

In helping to iron out the niggles with digital workflows, KLAS might well be helping to accelerate market maturity. “It feels very rewarding when we learn about the impact of our work,” says Rasband. “It’s what gets us out of bed in the morning.”

Asking key questions

When asked about the key questions that customers should be asking vendors, Lageman and Rasband are in their element:

• Is the solution mature, or still being developed?

• Will the solution support AI, genomics, and future workflows?

• Will this vendor guide us through transformation?

• What support, training, and best practices are provided?

• What are other labs experiencing?

On this last point, Lagemen says peer validation is invaluable. “Talk to early adopters,” he advises. “Ask about their challenges and successes, and which vendors they rate as good partners.”

From digitization to transformation

While digital pathology is in its infancy, Rasband is optimistic about its acceleration. “Pathology will become digitally enabled faster than radiology, because all the learnings from radiology can be applied,” she says. “For example, many institutions are adopting the Chief Medical Informatics Officer (CMIO) role – to serve as a bridge between medical and information technology departments – and they're getting more and more involved in imaging.”

Rasband also cites global collaboration as an accelerator for digital pathology. “Eder and I toured a digital pathology lab in Sweden some years ago,” she recalls. “It was exciting to come back and tell US labs all about it, long before it was on their radar. Now we see US people presenting at European conferences, and vice versa – everyone learning from each other. If you look at enterprise imaging, the US is actually leading now in terms of the evolution of vendor neutral archives and image management.”

While AI is currently the fastest growing market within digital pathology, Rasband cautions that full adoption is needed before it can scale. “If you do not receive a strong implementation, including effective hand-holding on the training portion, then even if it's the best software ever, it's not going to work,” she says. “And, in that case, it's not going to be rolled out.”

The difference is data

In a complex, evolving market, independent data is critical. And, as we've heard, it does more than just help labs choose wisely; it helps vendors improve and adoption move forward. KLAS reports demonstrate that, in digital pathology’s transition from promise to practice, trusted peer insight may be as important as the technology itself.

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