Drivers of Digital Pathology Adoption for Clinical Practice: An Experience from a Single Large Academic Institution

ABSTRACT

Background: Digital pathology has enormous potential to make routine pathology practice more efficient and accurate, however, full adoption has been slow. We aimed to identify driving factors that encourage pathologists to adopt digital pathology for their daily practice at our institution. Design: We have collected data on four indicators of pathologist adoption since the implementation of digital pathology (1) number of pathologists receiving training and certification for primary diagnosis using digital whole slide images (WSI);(2) average daily number of users logged in imaging managing system (IMS);(3) average daily number of primary diagnosis slides scanned;and (4) average daily number of slides scanned for immediate pathologist use (including consultation, urgent cases, etc.) Since adoption of digital workflow was voluntary and slides were only scanned for pathologists who have indicated to use WSIs for routine practice, these are accurate indicators of pathologists' transition from glass slides to digital workflow. These data were correlated with potential events during the study period. Results: The data of four indicators were summarized in the table. We observed two spikes the first one was from July to September 2019 and the second was from March to May 2020 (Figure 1). The first spike correlates with our pathology laboratory information system (LIS) transition from Sunquest Copath to Epic Beaker, which enables single-click access to WSIs in IMS from case working drafts. Previously, pathologists had to switch from pathology LIS to IMS and type in case numbers in order to access WSIs. The second spike correlates with the beginning of COVID-19 pandemic when many academic activities transitioned from live to remote using digital platforms. The need to work remotely, conduct education and consultation at distance, and minimize interaction with others appears to have driven many fence-sitting pathologists to adopt digital pathology. CMS waiver to loosen regulatory requirements during this pandemic has hastened pathologists' decision to switch to digital pathology for primary diagnosis. Conclusions: Our data suggests that ease of use and the ability to work remotely are the most powerful drivers of digital pathology adoption. (Table Presented).