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Digital Pathology Initiatives and Experience of a Large Academic Institution During the Coronavirus Disease 2019
Giovanni M Lujan1, Johanna Savage1, Arwa Shana'ah1
1From the Department of Pathology, The Ohio State University Wexner Medical Center, Columbus. Lujan and Li are co-lead authors.
Insights
The COVID-19 pandemic accelerated digital pathology adoption. Pathologists increasingly used whole slide imaging for remote diagnosis, with most intending to continue post-pandemic.
Area of Science:
- Digital pathology
- Medical informatics
- Pathology informatics
Background:
- The COVID-19 pandemic necessitated rapid adaptation in medical practices, including pathology.
- Digital pathology tools were increasingly integrated into routine workflows.
- The pandemic highlighted the need for remote diagnostic capabilities.
Purpose of the Study:
- To document the experience of implementing digital pathology for remote primary diagnosis, education, and research during the COVID-19 pandemic.
- To assess the impact of the pandemic on the adoption of digital pathology tools among pathologists and trainees.
Main Methods:
- A survey was conducted among subspecialized pathologists and trainees to collect data on digital pathology tool usage before and during the pandemic.
- Quality assurance and slide distribution data were analyzed.
- Surveys captured usage of whole slide imaging (WSI) for primary diagnosis and remote work.
Main Results:
- The number of pathologists using WSI for primary diagnosis increased significantly during the pandemic (62.5% to 90.6%).
- The use of WSI for exclusive primary diagnosis also saw an increase (6.3% to 15.6%).
- A majority of pathologists (86%) expressed intent to continue using WSI for remote primary diagnosis post-pandemic.
Conclusions:
- The pandemic acted as a catalyst for the adoption of digital pathology workflows.
- Pathologists recognized the logistical and technical advantages of digital pathology tools.
- Digital pathology facilitated a smooth transition to remote clinical and academic activities.
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 use 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%) of a total of 32 pathologists, excluding renal pathology and hematopathology, during the pandemic. Furthermore, the number of pathologists exclusively using whole slide imaging for primary diagnosis also increased from 2 (6.3%) to 5 (15.6%) during the pandemic. In 35 (100%) survey responses from attending pathologists, 21 (60%) reported using whole slide imaging for remote primary diagnosis following the Centers for Medicare and Medicaid Services waiver. Of these 21 pathologists, 18 (86%) responded that if allowed, they will continue using whole slide imaging 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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