Digital Pathology: Turning Challenges into Opportunities

Contributing Lab Leaders: Jeffrey Myers, MD, PhD and Julia Dahl, MD

LEADERSHIP

Article highlights:

The challenges you face with digital pathology are legitimate—but can easily be turned into opportunities
Adapt intelligently by stretching your comfort level without breaking it
Digital pathology can facilitate more meaningful interactions with clinicians and help you pursue a more consultative role

The age of digital pathology is upon us. It is the wave of the future, increasingly gaining momentum today. And while it opens up many exciting new opportunities for the medical practice of pathology, it also presents some very real challenges.

Do you feel those challenges? Do you worry that digital advancements may render your role obsolete? Do you want to do all you can to ensure your lab remains essential? Then read on. We’ve convened experts to help guide you.

It’s All in Your Mind

First know this: if you are a traditionally trained pathologist struggling with pixelated images or fumbling with mouse movements that feel unnatural it is all in your mind.

Consider Julia Dahl’s view on the subject.

It’s All in Your Mind

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Julia Dahl, MD

Assistant Professor; Department of Pathology. Associate Director; M-Labs

Michigan Medicine

No wonder you’re struggling with digital pathology. The digital interface is like a foreign language. Your neural pathways have never been trained to understand it. Gone are the tactile sensations that were part of your very identity as a pathologist. The click of glass on the stage. The sharp edge as you drive the slide. The twist of the knob yielding perfect image resolution in milliseconds.

In short, the challenges you’re struggling with are perfectly legitimate.

Adapt Intelligently

So what do you do? Try to selectively adapt to digital pathology. If it negatively impacts your diagnostic accuracy, stick with glass slides. That’s what Julia Dahl does. She can get her work done five times faster with glass. So she adapts intelligently, sticking with what works best for her and digitizing images later.

Make "adapt intelligently" your mantra. But understand there are important adaptations you will have to make to turn challenges into opportunities.

A Double-Edged Sword

One of those adaptations is to become more interactive with clinicians and patients. That means getting out of the lab and onto the floor whenever possible. Face-to-face interactions lead to more meaningful relationships.

But digital pathology is a double-edged sword. It can cut off vital relationships with clinicians. Before, you may have been consulting with them over slides in your lab. Now, you talk about digital images over the phone. You can’t make eye contact, read body language, or develop a relationship.

And yet, digital pathology offers incredible advantages. Take a tumor board as an example. Instead of pulling slide trays, the lab staff simply retrieve digitized images. Images that can be pulled from any location and shared with people in different time zones. "Digital imaging in pathology is doing what PACS (picture archiving and communication system) did for radiology," says Julia Dahl.

And in those cases when face-to-face interactions are not possible? Digital pathology can also help—if you wield it right.

Be Interactive

Discover ways to create meaningful interactions—both face-to-face and virtually

Get out of the lab and into the lounge

Be present. Clinicians should always recognize your face when they see your profile on LinkedIn, or if they run into you enjoying a cappuccino in the lounge. Embrace every opportunity to stake a claim for pathology outside the lab. It will make a difference in patient care and help pathology as a medical discipline.
Know who’s on the surgery schedule

Don’t just wait for the specimen, says Jeff Myers. Be proactive. Talk to the clinician to ensure the procedure makes sense. Rely on what you know and what has been done so far. Discuss the next step: resection, biopsy, or whatever the case may be. In this way, you demonstrate value as a clinical consultant.
Use video teleconferencing platforms

When face-to-face interactions are not possible, rely on a video teleconferencing platform as a surrogate. VSee is a favorite of Julia Dahl’s. It is HIPPA-compliant and has an option that requires clinicians to schedule time with you—reinforcing how important your time is.
Don’t let introversion keep you inside

Julia Dahl has some great advice for introverts—because she's one too. First, know you can get out and interact. But it will cost you some energy. Be prepared. Write an extroverted persona for yourself. Then get out there and be that persona. When it’s done, treat yourself to the alone time you need to recharge.
Partner with patients

When pathologists communicate with patients, it positively impacts the care experience. Julia Dahl recommends you always introduce yourself as a "doctor." Explain you’re the doctor who looks at tissue under a microscope. You are part of the care team that will help the patient be well again. This establishes trust.

Have the Courage to Consult

Digital pathology may further commoditize the collection of specimens and the production of images. It could even render such work obsolete at many local labs. In one model, the work might be centralized at a high-volume regional lab. Digital images would then be sent electronically to local diagnosticians.

Scenarios like this can engender fear. Having the courage to consult is the appropriate response to such concerns.

On Fear as a Call to Action

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Jeffrey Myers, MD, PhD

Vice Chair for Clinical Affairs & Quality; Director, MLabs

University of Michigan Health System

On Consultative Relationships

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Julia Dahl, MD

Assistant Professor; Department of Pathology. Associate Director; M-Labs

Michigan Medicine

"Suite Talk" Your Way to Success

So how do you get started on the road to a more consultative role? Jeff Myers recommends you first gather data from a series of small pilot studies. This will help you make the case to your C-suite.

For an example of a pilot program, read "How labs can optimize test-ordering patterns in oncology."

As you prepare that case, find out what matters to your C-suite. A well-thought-out strategy may garner you the support you need.

Digital Pathology

Turn your challenges into opportunities

It’s all in your mind – recognize that your challenges are legitimate, and often a function of how your neural pathways have been trained
Adapt intelligently – change with the times, but stick with the tried-and-true when it works best clinically
Become interactive – embrace every opportunity to engage with clinicians and patients, for the benefit of all
Be consultative – pursue opportunities to be part of the clinical consultative team, throughout the continuum of care
Speak the language of your C-suite – understand the metrics they’re looking for and construct pilot programs accordingly