LQHS2502 - CMLE - Pathology Informatics Workflow in an Academic Laboratory-Pathology Informatics Workflow in an Academic Laboratory

Pathology Informatics Workflow in an Academic Laboratory

Pdf Summary

This document from the University of Minnesota addresses digital pathology integration in anatomic pathology laboratories, focusing on whole slide imaging (WSI), quality management, and workflow optimization.<br /><br />Digital pathology involves creating high-resolution digital images of histologic slides to facilitate diagnosis, telepathology, education, and archiving. WSI stands out among telepathology tools for its ability to permanently store comprehensive histopathological images, enabling remote consultations and compliance with regulatory and educational needs. Despite its benefits, digital pathology faces challenges such as high costs, technical complexities, laboratory workflow integration, and pathologist training requirements.<br /><br />The College of American Pathologists (CAP) has issued validation guidelines for digital pathology use, recommending: 1) at least 60 representative cases for validation, 2) a minimum 95% concordance rate between glass and virtual slide interpretations, and 3) a minimum two-week interval between reviews of glass and digital slides.<br /><br />A typical digital pathology-enabled histology workflow integrates specimen accessioning, barcode tracking, processing, staining, WSI scanning, and LIS/EHR integration for seamless image review. Essential components include slide scanners, robust IT infrastructure with cloud or local storage, validated LIS and electronic health record integration, and a strong quality management system (QMS).<br /><br />Quality management in digital pathology spans three phases: preanalytical (specimen processing and slide preparation), analytical (digital scanning and image capture), and postanalytical (image upload, pathologist review, reporting, and archiving). Each step requires rigorous quality checks to ensure diagnostic accuracy. The QMS includes leadership oversight, equipment/vendor management, IT/software support, feedback mechanisms, and staff training to support change management.<br /><br />Troubleshooting digital pathology issues involves assessing slide quality, scanning processes, software functionality, network connectivity, and coordination among histotechnologists, pathologists, IT staff, vendors, and laboratory leadership. Alternate protocols should be in place to maintain clinical reporting during digital system downtimes.<br /><br />A clinical case exemplifies these concepts: a consultation liver biopsy slide initially failed digital upload due to improper barcode labeling. Correcting the barcode placement and rescanning resolved the issue with minimal delay. Feedback from this event led to improvements in error message visibility within the digital pathology system.<br /><br />The document highlights ongoing digital pathology adoption challenges; as of mid-2025, only about one-third of US surgical pathology labs use WSI, despite FDA approval of AI/ML solutions to augment pathology practice.<br /><br />In summary, successful digital pathology implementation requires strategic planning, infrastructure investment, pathologist engagement, integrated LIS and EHR systems, and comprehensive quality management to ensure prompt, accurate pathology diagnostics in a digital-first environment.

Keywords

Digital Pathology

Whole Slide Imaging (WSI)

Quality Management System (QMS)

Anatomic Pathology Laboratories

Telepathology

Workflow Optimization

College of American Pathologists (CAP) Validation

Laboratory Information System (LIS) Integration

Pathologist Training

Digital Pathology Challenges