Pathologists play a key role in accurate diagnoses, treatment plans, and ultimately, patient outcomes. But despite how important our work is, most of us rely on tools and workflows that are stuck in the past.
Glass slides and light microscopes – largely unchanged for more than a century – remain central to anatomic pathology. While reliable, these methods have limitations that affect not only the speed of diagnosis but also collaboration with clinicians and communication with patients. Traditional pathology workflows are slow and cumbersome; for example, physical slides must be shipped for consultations, stored in bulky archives, and reviewed manually. These steps also make it harder to share results seamlessly with other clinicians or to involve patients in their diagnostic journey. The question is: how can we preserve the strengths of established methods while also taking advantage of the opportunities digital technology now provides?
Moving toward digital pathology is not just about upgrading microscopes or scanners. It should represent a full shift in how we approach diagnosis and collaboration. In recent years, pathologists have increasingly adopted digital platforms that allow whole-slide imaging, cloud-based storage, and remote access. My own institution recently launched such a system in partnership with Google Cloud. Cloud platforms hold promise for faster, more accurate diagnoses – especially when combined with AI – and for improved communication across specialties, regardless of location.
This transition mirrors what radiology underwent a few decades ago, when the field moved from film-based X-rays and physical printouts to fully digital imaging stored in picture archiving and communications systems (PACS). That shift transformed radiology, improving efficiency, image quality, and collaboration with the wider care team. Pathology now stands at a similar crossroads, and the lessons learned in radiology – adopting new technologies while reshaping workflows – can help guide the way forward.
Switching to digital pathology comes with challenges. Interoperability between systems, agreement on data standards, and integration into existing workflows remain significant hurdles. Pathology images are large and complex, so secure and efficient sharing is essential. Implementing these tools also requires training for staff and close collaboration with IT and clinical teams.
From a clinical perspective, digital pathology could also enhance patient engagement. Traditionally, patients have had limited access to their pathology results beyond what physicians communicate. Digital platforms could change this by allowing patients to view their images, ask questions directly, and gain a clearer understanding of their diagnosis. Greater transparency may build trust and improve satisfaction, though it also requires careful communication to ensure findings are explained clearly and sensitively.
In my view, however, one of the greatest advantages of digital pathology is scalability. Digital platforms make it easier to share cases across departments and institutions, giving smaller or resource-limited laboratories access to expert opinions without geographic barriers. Cloud-based systems can handle large volumes of data and users, supporting growth without the need for extensive local infrastructure. This enables laboratories to process more cases efficiently – an important consideration given the rising demand for pathology services and the shortage of active pathologists. Greater scalability could help address workforce gaps, shorten turnaround times, and improve diagnostic consistency across regions.
Moving to digital pathology requires more than new technology. It calls for cultural and organizational change in how we work. Success will depend on leadership within the pathology community, strong collaboration with technology partners, and a commitment to thorough validation and standards.
This is a pivotal moment for our field. By embracing digital tools thoughtfully, pathologists can strengthen accuracy, collaboration, and patient care – ensuring that pathology remains vital, adaptive, and patient-centered well into the future.
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