A one-stop shop for digital pathology

Pathology has invested heavily in digital pathology, but that investment will only pay off if this new way of working is adopted by staff and results are reported digitally, argues Jake Morrow.

As the leading provider of Laboratory Information Systems, Clinisys is committed to helping labs to deliver. It has developed Clinisys WinPath XT, an optional bundle for WinPath, as a single product to simplify the roll-out of digital pathology and make sure tests are conducted and reported within the most appropriate system – the LIS.

Pathology has made a significant investment in digital pathology. That’s particularly evident in cellular pathology, in which the traditional glass slide is digitised so it can be viewed on a computer screen, rather than through a microscope.

The case for investment is that digital pathology will make the best use of increasingly scarce pathology staff, improve the efficiency of workflows, and speed up diagnosis – particularly for cancer.

However, you can only deliver these benefits if your laboratory is reporting digitally. If you just add a scanner, you have just added an expensive step to your process.

Where should we report?

Almost every laboratory in the country has put a business case together for digital pathology and many have taken delivery of their scanners. As things stand, though, just a handful are reporting digitally, and they have taken different approaches.

Some labs are using the Picture Archiving and Communications System, while others are committed to using the Laboratory Information System. The PACS may look like a good option, because it was built to handle digital images, and is likely to have a solid footprint across a cancer network perhaps built upon radiology foundations.

But the LIS is the better option. Using the LIS will mean that digital cellular pathology is subject to the same workflow and governance as other areas of pathology, and that results can be reported alongside other tests that are likely to impact a patient’s treatment.

Using the LIS also puts you in a better position for the future, as more areas of pathology become digitised, and more tests – including genomic tests – are brought in to support diagnosis and treatment. You need to think now about that bigger picture to avoid creating more and more pockets of results as these innovations come on stream. Having a single source of truth is important.

Clinisys WinPath XT: one solution for digital pathology

One challenge to using the LIS has been that the LIS has historically lacked some of the capabilities required. This has led some laboratories to work with third-party providers of these capabilities.

Clinisys is committed to interoperability, so we will always support customers that want to move in this direction. However, we can now offer an alternative – Clinisys WinPath XT. This is one product to make sure you can adopt digital pathology in the most efficient and effective way, and its modules include the following capabilities:

Printing at each workstation: Cellular pathology needs to print labels containing information about a specimen’s journey through the lab, from arrival to dissection to embedding in wax to slicing and mounting on the glass slide. So, we are enabling that through the Specimen Processing Module.

Specimen processing: Traditionally, the LIS has lacked the capacity to track blocks and slides through the lab, but from the beginning of 2025 our cloud-based Specimen Processing Module will have the necessary functionality. This will not just support the introduction of digital cellular pathology but help laboratories to meet their UKAS requirements.

VUE Diagnostic Console: Cellular pathology needs to start a report early in the workflow. After a case is booked in, the specimen needs to be described at the macro level. From the beginning of 2025 it will be possible to report the gross description using VUE in the laboratory. VUE is our complete solution for integrated reporting. VUE captures diagnostic and patient data from a range of IT systems and enables the clinician to view and work with it in one place.

Support for MDT meetings: Another important aspect of VUE is that it has features to enable pathology to play a full role in Multi-Disciplinary Team meetings. With VUE, you can tag reports and draw up a list of cases, with images and full diagnostic profiles. All the information can be accessed remotely, so participants can have access in the MDT meeting room or a video conferencing solution, if they are attending virtually.

mTuitive xPert: mTuitive is an expert in synoptic data capture and its’ xPert solution is built around templates and checklists that both speed up the reporting process, improve the clarity of reports, and make them clearer for the end-user.

Again, xPert will not only support the introduction of digital pathology, but current challenges; in this case complying with the new schema introduced by the Cancer Outcomes and Services Data Set (COSD), which no longer accepts the wide range of text and other evidence that was accepted previously. Clinisys has worked with customers and the cancer registries to ensure compliance to the latest schemas to free up valuable staff time with auto submission.

Analytics capabilities: Pathology managers need to know what is happening in their labs and how their workflows and clinicians are performing. Clinisys WinPath XT comes with management reporting capabilities. Currently, these are delivered by Pathology Manager; but new and exciting analytics are on the way.

Integrations and AI: Clinisys WinPath XT has been designed as a complete package with tight third party integration for image management and genomic investigation.

Increasingly, it might also include integration with outputs from an Artificial Intelligence. AI is a buzzword right now, but we’re already seeing practical applications for it. Let’s say you have a case of breast cancer. You have the glass slide, or the digital image, and the reporter thinks it is breast cancer, and decides to add a test for HER2. In future, AI could have looked at the image and added that test upfront, so that by the time the reporter sees the case, the additional information is already available. That will save a lot of time. But it’s important that the AI results are available, so the clinician remains in control of the report. If they’re in the LIS, then we can see, report, and use them. AI output is really just like another laboratory test result from the LIS perspective.

Making digital pathology work for your service and staff

Clinisys WinPath XT has been put together as a one stop shop package for laboratories that want to embrace digital pathology and to make sure that it delivers the promised time and efficiency benefits. If you are going digital, you don’t need to work out what additional, third-party capabilities you need.

You leave us to focus on those details, while you focus on implementation. The Clinisys WinPath XT package should also make it easier for your service staff to implement what has been called the biggest change to pathology in a generation.

That’s because it can support both traditional and digital pathology workflows. So, if some clinicians are not ready to move away from the glass slide and the microscope just yet, you can allow them to carry on working, until they are ready. All the information will still be captured, managed, and reported through the LIS.

Making the most of investment

This takes us back to where we started. Pathology has invested heavily in digital pathology, but that investment will be wasted unless the results are reported digitally, and pathologists embrace this new way of working.

As a supplier, we want to make sure the investment is not wasted, and that’s why we’ve created Clinisys WinPath XT: a one stop-shop for digital pathology that keeps data in the LIS, works for your service, and supports your most valuable resource, your staff.