Flexible – but robust – solutions
Many pathologists may think, “I’m in a very strong standalone department. I don’t see the need (or there’s no pressure on me) to collaborate or take in work from anywhere else.” But even those who don’t think they have an immediate need for collaboration can still benefit from digital technology – so the best way to approach purchasing is to make sure your chosen IT solutions are flexible. They need to be scalable, of course – but they also need to allow users to “cherry-pick” the technologies they want. You should be able to say, “I don’t want to buy a solution that only works with a certain scanner. I want to buy one that lets me have this scanner here, that scanner there, and yet another scanner for other types of work.” The more compatible a solution is with the equipment you already use – or may want to use in the future – the better it will serve you.
I find that the questions users ask at the start of their digital journeys aren’t the same ones they ask after they’ve gained a level of familiarity. When you first invest in technology, you ask things like, “What core features does it have? What can it do?” When you’re in your second or third generation, as radiologists are now, you ask, “How stable is it? What’s your customer satisfaction like? What’s your downtime? How often do you upgrade? What support services do you offer?” The biggest negative effect on efficiency and productivity is unexpected downtime – something you only find out through experience. And when clinicians and patients are depending on your results, you quickly learn to avoid anything that might create delays.
Consider what would happen if all of a hospital’s radiology services were unavailable for a day – or even just a few hours. Some patients wouldn’t be able to undergo surgery; emergency departments would be compromised in their ability to diagnose or treat; injured patients could be left without medical care until services were restored. Pathology is an equally critical service – without the laboratory, critically ill patients go undiagnosed, cancer treatments are postponed, and infections may be left to spread unchecked because clinicians can’t select the appropriate antibiotic. To avoid these kinds of issues, our technological solutions must be robust – and that may mean looking for technologies with good interoperability, so that each lab can create its own custom setup without building in known restrictions ahead of time. The monolithic approach is not always the right approach. A solution shouldn’t just offer its own, homegrown solution that may lag behind the curve of technology development; it should be open to plugging in bleeding-edge technologies and exciting new AI tools developed by small, agile companies. Integration and interoperability are the way to future-proof your service.
Developing a digital future
The next step forward is to incorporate artificial intelligence and machine learning into the available platforms for digital pathology. Fortunately, I think the researchers who are developing these technologies now understand that, to take them from a research lab and put it into a clinical setting, they have to understand the practical considerations involved. So now, many of those researchers are partnering with health service providers, such as the NHS to ask: “How can we make our algorithms work in such a crazy, chaotic environment? (Or – in other words – how can we take something that works in a research lab and make it work for all kinds of users in a much less controlled setting?) How does it fit into the existing workflow?” We want to see these technologies help medical professionals by taking away tedious chores (that machines do well and humans often dislike), freeing up time for clinicians to tackle more difficult tasks and deliver better patient care.
When I started my career as a radiographer, we used to print out magnetic resonance images on film and look at every single image individually; nowadays, that would be impossible with the thousands of images involved! Thankfully, in the meantime, we’ve developed solutions and algorithms that work with viewing technologies to manage the volume of data, highlight aberrances, and direct the human’s attention where the need is greatest, which helps modern radiologists cope with the sheer volume of data they see every day. It’s my hope that the same will be true for pathology; I want digital and computational methods to support people coping with a tsunami of information. Anything that can merge (almost) seamlessly into the existing workflow and go hand-in-hand with existing processes and technologies is welcome – that’s how new technologies become not just shiny new toys, but powerful enhancers of patient care.
1. Department of Health and Social Care, “Productivity in NHS hospitals” (2016). Available at: http://bit.ly/1FU1TzC. Accessed January 31, 2018.
This article was originally published in the March issue of The Pathologist magazine. Download issue #40 March 2018 here (PDF).