On the Edge of a Digital Pathology Transformation: Views from a Cellular Pathology Laboratory Focus Group

Abstract

Introduction:Digital pathology has the potential to revolutionize the way clinical diagnoses are made while improving safety and quality. With a few notable exceptions in the UK, few National Health Service (NHS) departments have deployed digital pathology platforms. Thus, in the next few years, many departments are anticipated to undergo the transition to digital pathology. In this period of transition, capturing attitudes and experiences can elucidate issues to be addressed and foster collaboration between NHS Trusts. This study aims to qualitatively ascertain the benefits and challenges of transitioning to digital pathology from the perspectives of pathologists and biomedical scientists in a department about to undergo the transition from diagnostic reporting via traditional microscopy to digital pathology.Methods:A focus group discussion was held in the setting of a large NHS teaching hospital's cellular pathology department which was on the brink of transitioning to digital pathology. A set of open questions were developed and posed to a group of pathologists and biomedical scientists in a focus group setting. Notes of the discussion were made along with an audio recording with permission. The discussion was subsequently turned into a series of topic headings and analyzed using content analysis.Results:Identified benefits of digital pathology included enhanced collaboration, teaching, cost savings, research, growth of specialty, multidisciplinary teams, and patient-centered care. Barriers to transitioning to digital pathology included standardization, validation, national implementation, storage and backups, training, logistical implementation, cost-effectiveness, privacy, and legality.Conclusion:Many benefits of digital pathology were identified, but key barriers need to be addressed in order to fully implement digital pathology on a trust and national level.

Digital Pathology: Advantages, Limitations and Emerging Perspectives

“…Furthermore, a UK pathology laboratory focus group published their views in 2019 [ 41 ] on a set of open questions on the imminent transition to DP at their department (Oxford University Hospitals, NHS Trust). They identified benefits (e.g., collaboration, teaching, cost-savings) but also barriers to transition (e.g., standardization and validation, training, cost-effectiveness, data storage) and proposed the setting up of multiple pilot centers in the UK.…”

“…Cost-effectiveness analyses based on standardized criteria, as suggested in [ 41 ], will provide more robust and comparable data in the future. Results need to be stratified by type of department (academic/non-academic), the extent of DP implementation, and ideally compared to other players in the field working under comparable reimbursement schemes.…”

Digital Pathology Transformation in a Supraregional Germ Cell Tumour Network

“…Engagement of the pathologists and the wider team within the department at OUHFT was an important aspect of the journey to DP. The focus group at the outset provided an insight into the general perceptions of the group [ 8 ]. There were nine respondents to the subsequent online survey of the pilot group (seven histopathologists), which revealed the aspirations of the group in respect to the promise of DP to improve aspects of patient safety, diagnostic workflow, workforce planning, and service quality, very much in line with those reported by others [ 11 ].…”

“…This was part of the effort to engage the group to ensure that the process would be supported. An initial focus group explored the issues [ 8 ] and subsequently an online survey was circulated to the 13 members of the DP steering group using the SurveyMonkey survey tool ( ; accessed on 13 October 2021). The survey was designed to assess both general considerations related to the transition to DP, and more focused questions addressing the predicted ‘benefits’ of adoption of DP.…”

Challenges Developing Deep Learning Algorithms in Cytology

“…It is necessary to develop regulatory frameworks to determine when data can be used without explicit patient consent (even if patient data are anonymized), and what type of data can be shared and utilized to develop algorithms [35]. Legal institutions, bioethicists, and other relevant groups will need to be consulted in this regard.…”