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Digital Pathology: The Glue That Holds The Distributed Team Together

Stephan Fromme
By Stephan Fromme | August 16, 2021

As laboratories address the shift to remote work, Dr. Nicolas Cacciabeve discussed how digital pathology is becoming the standard for enabling remote peer review and consultations.

Pathologists have always been highly collaborative, working together to carry out their commitment to excellent patient care. The widespread adoption of digital pathology is taking collaboration to a new level, as the transition to whole slide imaging overcomes the limitations of glass slides. Images can be sent for consultation in a few clicks, driving powerful efficiencies and reducing turnaround times. Similarly, a pathologist’s location no longer determines if she can participate in peer review, helping to improve diagnostic confidence. For these reasons among others, it’s hardly surprising that digital pathology adoption surged at the onset of the pandemic amid social distancing requirements and continues to accelerate as the shift to remote work becomes permanent.

At Proscia’s Future Ready Pathology event, I spoke with Dr. Nicolas Cacciabeve, Managing Partner at Advanced Pathology Associates, an independent pathology practice in the Mid-Atlantic region of the United States, during a session on “Connecting the Distributed Team: Powering Network and Remote Operations.” A digital pathology early adopter, Dr. Cacciabeve spoke about how the shift from microscope to image is unifying the pathologists across his organization and enabling new business opportunities, providing insights for laboratories undergoing a similar transformation today.

The pathologists on Dr. Cacciabeve’s team are up to 50 miles apart. He noted that digital pathology enables them to come together and “do peer review across the entire practice” with what he described as a “virtual multi-headed microscope.” Whereas prior to digitizing, his team would have to gather centrally in the evening, each pathologist can now participate from her office – or remotely – during the day. In turn, more experts can join, enhancing the quality of peer review and helping to improve diagnostic confidence for the patient. Dr. Cacciabeve also sees digital pathology improving diagnostic inter-observer precision. “Having the entire team review and comment on interesting or challenging cases leads to better standardization of the difficult ones.”

Dr. Cacciabeve then spoke to how digital pathology is benefitting consultations. Unsurprisingly, he highlighted that it can expedite consultations, reducing the time it takes to get a report to the clinician and a diagnosis to the patient. As he said, “The speed of getting glass slides to the consultant is the speed of traffic, but the speed of sharing whole slide images is the speed of the Internet.”

Looking ahead, Dr. Cacciabeve emphasized that by going digital, he’s laying a foundation for implementing computational pathology applications leveraging artificial intelligence, which can provide “a second consult for every case.” In fact, he believes the productivity gains that will result from AI will outweigh the cost of digital pathology adoption – so much so that AI-enabled digital pathology is his “best answer” to overcoming the predicted near-term shortage of pathologists.  

He expanded on the laboratory economics focus, exploring how digital pathology is opening new sources of revenue. He first mentioned that his network can bring sub-specialist expertise to smaller hospitals, which “is going to allow for his practice to grow.” A hospital that is only able to bring on one or two pathologists may find it beneficial to hire from a networked practice like Advanced Pathology Associates because it will also get the experience of the broader network. Digital pathology helps his practice to enhance its expertise as well. For example, he is now in discussion with an academic medical center about conducting real-time digital consultations from a neuropathologist on its staff. Importantly, both examples are not only providing Dr. Cacciabeve with opportunities to read more cases but also help to ensure a higher quality diagnosis for the patient through broader access to expertise.

My conversation with Dr. Cacciabeve was a great reminder of digital pathology’s impact on connecting distributed teams, driving efficiency and quality gains, and unlocking new sources of revenue – all critical benefits that we see more laboratories realizing as they continue to modernize. To hear our full discussion – and from other digital pathology pioneers – watch the Future Ready Pathology event here.

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