For all of its sophistication, digital pathology turns on just a few basic value propositions: images must be consistent, persistent and efficient, enabling them to be used at anytime and from anywhere. We need to get the right slide on the right patient to the right pathologist at the right time – what eminent pathologist and blogger Keith Kaplan, MD, calls “the 4R’s of digital pathology.”
When these four requirements are met, good things happen: teleconsultation and image analysis can be performed by the right pathologist on the right slide on the right patient at the right time. With this capability, pathology is moving from near real-time diagnoses to real-time diagnoses without regard to geographic boundaries.
Consider this, from Kaplan, in a recent Digital Pathology Blog:
“Much like our building materials, pool tables, clothing, toys, televisions, PCs, smartphones and a million other products… countries will export their pathology cases to the U.S. But instead of the cargo ships going back empty in our case, they will send back pathology support and reports to guide diagnoses, treatment, management and clinical trial management.
“The untethering of pathologist from microscope, histology lab and LIS is here and is now worldwide. One does not have to go back many years or USCAP meetings to remember folks concerned about “outsourcing of pathology services” to foreign countries. Naysayers over the years have said that beyond cost, support requirements, lack of IT resources, speed, workflow, user interface issues, network requirements, etc., one of the major impediments to the wide scale adoption of digital pathology has been a fear of ‘outsourcing.’ Our skills and services would be commoditized, sold on the open market to the lowest bidder and sent offshore.”
Kaplan notes that this hasn’t occurred and will not occur, and I agree. There are dramatic shortages of pathologists on many continents, lack of subspecialty expertise, and in-turn a lack of quality to ensure that standards of care are being met according to expectations of the American community. This focus on quality will become increasingly important as fee-for-service volume based models become pay-for-performance quality/outcomes-based models of care.
“While you may be better off going to Malaysia or India for your open heart surgery or joint replacement, Western pathology is still the best in the world and this technology offers us the opportunity to provide it on a scale to places that could not previously have access to do so,” Kaplan rightly observes.
Information technology benefits all markets, developing and developed. Increasingly, doctors on the ground in remote parts of the world are now able to link up with a quality pathologist partner, analyze their patients’ medical situations from different dimensions, and then effectively direct patient care. Using the web or the cloud to connect doctors and hospitals with qualified, certified pathologists – many from the top medical institutions in the U.S. – represents a sea change in diagnostics.
Digital pathology is already expanding the reach of every pathologist beyond his or her backyard to patients and practices the world over. This is visionary medicine at its best, at work to transform patient care and save lives on a global scale.
Jaye Connolly is CEO of PathCentral in Irvine, Calif.
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