Dr. Thomas Sollie is the Medical Director at Proscia, and Histopathology Consultant, Akademiska sjukhuset, Uppsala, and Universitetssjukhuset Örebro, in Sweden.
In its century-long history, the medical sub-discipline of pathology has experienced continuous change, improvement, and advancement. Today’s challenge is digital pathology, which digitizes specimen slides and lets pathology teams use computer-based technology to view, manage, share, and analyze those slides.
Digital pathology offers proven benefits. But humans generally dislike change, no matter how beneficial. What will it take to get pathologists to give up the comfort of their trusted microscope for a more modern monitor?
A lack of leadership is costly
Strong leadership is essential to make this digital transition successfully. Without this leadership, many departments aiming for complete digital transformation of their pathology operations end up in limbo. They make the leap to whole slide imaging for some of their work, but continue processing the rest of the images the old-fashioned way.
Here’s the problem: Having two different workflows running in parallel for the same type of task is not only inefficient, it’s also costly and elevates patient risk. Someone needs to keep track of which team members are working digitally and which still use analog tools. In practice, this means sorting slides – which is time-consuming work.
When scanners and powerful computers with high resolution monitors are underused because pathology workers prefer to stick with last-generation tools, it wastes technology investments made by private companies and public healthcare providers. What’s more, running parallel pathology systems – both manual microscope and digital slides – can increase turnaround times and delay diagnoses.
Follow these steps to successful transformation
What’s the best way to avoid these common transition problems? By establishing strong leadership from the start of the transformation journey, organizations can make the move to digital pathology – quickly, efficiently, and at a reasonable cost. Following are four key steps to create the leadership needed to drive a successful digital pathology project.
Make roles clear. Everyone on the project team – including vendors and internal clients – should understand their role in the transformation process. The project team may include representatives from your pathology group, laboratory personnel, administration, IT, and management. Vendor representatives may include personnel from sales, application specialists, IT architects, security officers, an installation team, and a project manager.
Assign decision-making authority. With so many roles, it is essential to identify the key decision-makers. Often the decision-making process is long, tedious, and confusing. Strive for a transparent hierarchy where it is obvious who has the authority, responsibility, and mandate to make decisions.
Choose a champion. One of your key decision-makers should be responsible for the practicalities of implementing digital pathology at the department level. By selecting a pathologist who can say, “follow me and do as I do” instead of merely giving out directives, you can boost your chances for success.
Limit the options for project failure. To avoid ending up in transformation limbo, appoint a decision-maker who can navigate the process with a warm, kind, and firm hand – without offering to keep the microscopes. To encourage the loading and unloading of slides, this decision-maker should be prepared to motivate staff by explaining how this new task is essential for the whole of digitalisation, and will improve efficiency by eliminating extra working hours and effort required by an analog workflow.
Complete the transformation. Of course, every department needs a transition period in which the old and new ways of working coexist. During this time, the organization validates the digital system and pathologists switch to reporting digitally. But the shift cannot stop there. The transition must occur on schedule. If specified deadlines are not met, leadership must follow up to learn why.
Resistance to change is only temporary
In any shift to new technology, some personnel will argue that digital pathology causes inefficiencies and other inferiorities. That will initially be true. But as digitization progresses, the advantages to your organization will emerge: increased patient safety, better collaboration options, improved ergonomics, no manual handling of slides, no paper referrals, and the possibility of easily working remotely. And then there’s the crown jewel of digital pathology: the benefits of AI.
If pathologists threaten to resign over digitization, remind them of the pre-laboratory information system era and the transition that followed. Only a few decades ago, medical secretaries used typewriters and carbon paper to create a report in two copies. Laboratory personnel hand wrote the case ID on the cassette, noted the number of blocks on the clinical referral. Pathologists ordered additional staining on a piece of paper, and used a pen to sign the report.
All of this changed with the introduction of digital laboratory information systems (LISs). LIS technology led to legible text throughout the process, better traceability, and improved patient safety. As with any major change in workflow, there were bumps along the way – for pathologists, laboratory technicians, and medical secretaries.
Yet in the end, employees of pathology departments were left with no choice but to adapt to the new digital workflow. The introduction of accreditation in regards to national standards, which started to include LIS, helped further. The same is likely to happen with digital pathology slide technology.
In the meantime, there’s no need to enable a limbo state. By taking these steps to lead confidently through your transformation, you can help your organization quickly achieve true digital pathology.
