The Future of Pathology: What can we Learn from the COVID-19 Pandemic?

Williams, Bethany; Fraggetta, Filippo; Hanna, Matthew G.; Huang, Richard S.P.; Lennerz, Jochen K.; Salgado, Roberto; Sirintrapun, S. Joseph; Pantanowitz, Liron; Parwani, Anil V.; Zarella, Mark D.; Treanor, Darren

doi:10.4103/jpi.jpi_29_20

Cited by 15 publications

(24 citation statements)

References 2 publications

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“…Social distancing measures have precluded the use of multiheaded microscopes and altered the educational modes that involve close resident‐faculty case evaluations. In light of social distancing mandates, web‐based video conferencing and remote teaching via digital teaching slides have been recommended for training in pathology and cytopathology departments in the United States 28,29 . However, web‐based learning is not a widely accepted style for teaching residents and fellows in most hospitals in the Asia‐Pacific region 29 .…”

Section: Discussionmentioning

confidence: 99%

“…In light of social distancing mandates, webbased video conferencing and remote teaching via digital teaching slides have been recommended for training in pathology and cytopathology departments in the United States. 28,29 However, web-based learning is not a widely accepted style for teaching residents and fellows in most hospitals in the Asia-Pacific region. 29 Moreover, we found that approximately 53.3% of the responding laboratories had rearranged their workflows and included more working in shifts and working from home; 34.1% reported either part-time or full-time deployment of cytology professionals to other aspects of patient care.…”

Section: Cancer Cytopathology December 2020mentioning

confidence: 99%

“…28,29 However, web-based learning is not a widely accepted style for teaching residents and fellows in most hospitals in the Asia-Pacific region. 29 Moreover, we found that approximately 53.3% of the responding laboratories had rearranged their workflows and included more working in shifts and working from home; 34.1% reported either part-time or full-time deployment of cytology professionals to other aspects of patient care. The data from the current study reflected the fact that the routine practice of case readouts had been altered and that face-toface instruction for residents was, as a result, somewhat limited in the majority of laboratories.…”

Section: Cancer Cytopathology December 2020mentioning

confidence: 99%

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Impact of the COVID‐19 pandemic on cytology practice: An international survey in the Asia‐Pacific region

Wang

Bychkov

Chakrabarti

et al. 2020

Cancer Cytopathology

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BACKGROUND: The purpose of the current study was to examine the impact of coronavirus disease 2019 (COVID-19) on various aspects of cytology practice in the Asia-Pacific region. METHODS: An online questionnaire was distributed to cytopathology laboratories in 24 Asia-Pacific countries to explore the impact of restrictive measures on access to health care, use of general and personal protective equipment (PPE), and changes in cytology workflow and workload from February to April 2020. RESULTS: A total of 167 cytopathology laboratories from 24 countries responded to the survey; the majority reported that restrictive measures that limited the accessibility of health care services had been implemented in their cities and/or countries (80.8%) and their hospitals (83.8%). The respondents noted that COVID-19 had an impact on the cytologic workflow as well as the workload. Approximately one-half of the participants reported the implementation of new biosafety protocols (54.5%) as well as improvements in laboratory facilities (47.3%). Rearrangement or redeployment of the workforce was reported in 53.3% and 34.1% of laboratories, respectively. The majority of the respondents reported a significant reduction (>10%) in caseload associated with both gynecological (82.0%) and nongynecological specimens (78.4%). Most laboratories reported no significant change in the malignancy rates of both gynecological (67.7%) and nongynecological specimens (58.7%) compared with the same period in 2019. CONCLUSIONS: The results of the survey demonstrated that the COVID-19 pandemic resulted in a significant reduction in the number of cytology specimens examined along with the need to implement new biosafety protocols. These findings underscore the need for the worldwide standardization of biosafety protocols and cytology practice.

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Section: Discussionmentioning

confidence: 99%

Section: Cancer Cytopathology December 2020mentioning

confidence: 99%

Section: Cancer Cytopathology December 2020mentioning

confidence: 99%

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Impact of the COVID‐19 pandemic on cytology practice: An international survey in the Asia‐Pacific region

Wang

Bychkov

Chakrabarti

et al. 2020

Cancer Cytopathology

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“…For example, a survey of tertiary UK hospitals reports 2 indicated an increase in uptake of diagnostic DP during this period, supported by the implementation of remote access solutions and a fast roll-out of emergency guidance on how to risk-assess home reporting of digital slides by the Royal College of Pathologists. 3 Italian regions with particularly severe COVID-19 case loads report the utilisation of DP solutions to support pathology work in the face of severe logistical constraints. 4 It was recognised early that diagnostic delays could lead to a severe impact on public health and that continued operation of diagnostic services was critical to maintain timely diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Update on the current opinion, status and future development of digital pathology in Switzerland in light of COVID-19

et al. 2021

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AimsThe transition from analogue to digital pathology (DP) in Switzerland has coincided with the COVID-19 crisis. The Swiss Digital Pathology Consortium conducted a national survey to assess the experience of pathologists in dealing with the challenges of the pandemic and how this has influenced the outlook and adoption of DP.MethodsA survey containing 20 questions relating to DP, personal experiences and challenges during the pandemic was addressed to Swiss pathologists at different experience stages in private practice, community and university hospitals.ResultsAll 74 respondents were pathologists, with 81.1% reporting more than 5 years of diagnostic service experience. 32.5% reported having read 100 digital slides or more in a diagnostic context. 39.2% reported using whole slide imaging systems at their primary workplace. Key DP use cases before the COVID-19 lockdown were tumour boards (39.2%), education (60.8%) and research (44.6%), with DP used for primary diagnosis in 13.5%. During the COVID-19 crisis, the use of DP for primary diagnostics more than doubled (30% vs 13.5%), with internal consults as important drivers (22.5% vs 16.5%), while research use (25% vs 44.6%) and external consults (17.5% vs 41.9%) strongly decreased. Key challenges identified included a lack of established standard operating procedures and availability of specialised hardware and software.ConclusionsThis survey indicates that the crisis acted as a catalyst in promoting DP adoption in centres where basic workflows were already established while posing major technical and organisational challenges in institutions that were at an early stage of DP implementation.

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“…9 As we continue to learn more about the virus, laboratories and hospitals have seen an increase in the demand for DP and remote services to address new safety and practice restrictions. [10][11][12][13] In the United States, the Centers for Medicare and Medicaid Services (CMS) responded to these challenges by issuing a waiver that allowed pathologists to work remotely. In particular, the waiver stated that CMS would ''not enforce the requirement to have a separate certificate for laboratories that are located at a temporary testing site, provided that the designated primary site or home base has such a certificate (using the address of the primary site) and the work being performed in the temporary testing site falls within the parameters of the primary site's certificate ( §493.35(b) (1).…”

mentioning

confidence: 99%

Digital Pathology Initiatives and Experience of a Large Academic Institution During the Coronavirus Disease 2019 (COVID-19) Pandemic

Lujan

Savage

Shana’ah

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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Context. Pathology practices have begun integrating digital pathology tools into their routine workflow. During 2020 the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged as a pandemic causing a global health crisis that significantly affected the world population in several areas, including medical practice, and pathology was no exception. Objective. To summarize our experience in implementing digital pathology for remote primary diagnosis, education and research during this pandemic. Design. We surveyed our pathologists (all subspecialized) and trainees to gather information about their use of digital pathology tools before and during the pandemic. Quality assurance and slide distribution data were also examined. Results. During the pandemic, the widespread usage of digital tools in our institution allowed a smooth transition of most clinical and academic activities into remote with no major disruptions. The number of pathologists using whole slide imaging (WSI) for primary diagnosis increased from 20 (62.5%) to 29 (90.6%) out of a total 32 (100 %) pathologists, excluding renal pathology and hematopathology, during the pandemic. Furthermore, the number of pathologists exclusively using WSI for primary diagnosis also increased from 2 (6.3%) to 5 (15.6%) during the pandemic from the total of 32 (100%) pathologists. From 35 (100%) survey responses from attending pathologists, 21 (65.6%) reported using WSI for remote primary diagnosis following the Centers for Medicare and Medicaid Services waiver. Of these 21 pathologists, 18 (87%) responded that if allowed, they will continue using WSI for remote primary diagnosis after the pandemic. Conclusions. The pandemic served as a catalyst to pathologists adopting a digital workflow into their daily practice and realizing the logistic and technical advantages of such tools.

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The Future of Pathology: What can we Learn from the COVID-19 Pandemic?

Cited by 15 publications

References 2 publications

Impact of the COVID‐19 pandemic on cytology practice: An international survey in the Asia‐Pacific region

Impact of the COVID‐19 pandemic on cytology practice: An international survey in the Asia‐Pacific region

Update on the current opinion, status and future development of digital pathology in Switzerland in light of COVID-19

Digital Pathology Initiatives and Experience of a Large Academic Institution During the Coronavirus Disease 2019 (COVID-19) Pandemic

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