Creating a fully digitised pathology network

Faced with increasing demand for histopathology services in a vast but sparsely populated area in Australia, Sullivan Nicolaides Pathology (SNP) was looking for ways to increase its workflow efficiency while reducing diagnostic turnaround times for regional and rural patients.

SNP is one of the largest members of the global Sonic Healthcare Group. The company offers high-quality pathology services to doctors, private hospitals and nursing homes in Queensland, northern New South Wales and Darwin — operating from laboratories in Brisbane, Toowoomba, Townsville and other locations along the east coast.

Servicing such a vast area with a thinly dispersed population creates logistical and financial challenges for SNP. Transporting tissue specimens of patients between locations for laboratory inspection adds to turnaround times for regional histopathologists, with physical shipping carrying a price tag as well. At the same time, demand for histopathology services is on the rise, with an expectation of faster diagnoses.

SNP recognised that digitising its pathology processes could enhance the delivery of high-quality, accessible healthcare to regional and rural patients, in a cost-effective manner that sustains business growth. With digital pathology, scans of patient tissue slides can be quickly shared for collaboration across laboratory sites.

Between 2013 and 2016, SNP assessed digital pathology solutions from four different vendors. SNP unanimously chose to proceed with digitisation using the Philips IntelliSite Pathology Solution, identifying it as delivering “consistently superior image quality, providing the confidence needed to perform diagnosis from scanned images”, the company said.

The Philips solution also yielded the shortest average scan time in the SNP laboratory environment, scanning 37% more slides per hour than the model with the longest scan time. Easy integration into existing laboratory workflow was another decisive factor behind SNP’s choice.

SNP is now on track to become what is believed to be Australia’s first fully digitised pathology laboratory. And according to Dr Mark Wyche, histopathologist at SNP in Toowoomba, the benefits are numerous.

“Digital pathology has enhanced our practice with an improved workflow that helps to speed up diagnostic turnaround times for patients,” Dr Wyche said. “I can now send specimens for immunochemistry with the evening courier to our Brisbane laboratory where they will be prepared, scanned and ready for me to review on screen the following morning. The technology has also facilitated collaboration. Digitised slides are convenient for the rapid sharing of diagnostic material with other histopathologists from remote locations.

“Collaboration with clinical colleagues has benefited as well. In multidisciplinary team meetings, scanned slides are a convenient method of demonstrating pathology to clinical colleagues. Surgeons and oncologists are able to review diagnostic images and more readily appreciate factors which are clinically relevant.”

SNP has now been using digital pathology for several years. Dr Wyche said, “This allows for rapid review of archived tissue scans, which is useful for clinical meetings and routine practice in order to assess disease progress or determine response to treatment.”

SNP is also developing archives of scanned images for teaching purposes, as physically sharing slides for training among histopathologists can be cumbersome. Digitisation has sped up this process, enabling ongoing education to maintain competency and accreditation of SNP’s histopathologists for excellent service delivery.

As a future direction, digital pathology opens the door to computational pathology — the combination of multiple sources of patient data and mathematical models to generate diagnostic inferences. Potential uses for SNP include the automated review and division of work into clinically high and low risk cases, pre-identification of tumour tissue, and the identification of information undetectable to the human eye.

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