About Nisha Patel

What gaps in technology/training/processes concern you most, and how are you addressing them via innovation?

One of the greatest challenges is ensuring that laboratory systems keep pace with rapid scientific discovery. Evolving disease classifications, targeted therapies, and genomic profiling require hematopathologists to integrate morphologic, immunophenotypic, molecular, and clinical information into more comprehensive diagnostic reports. Yet these expanding responsibilities coincide with persistent workforce shortages and increasing regulatory complexity. Addressing these gaps requires innovative approaches to streamlining workflows, strengthening the workforce, and rapidly translating emerging knowledge into clinical practice. Working at the NIH Clinical Center, I encounter these challenges daily and strive to address them through each of these avenues.

As Director of the Flow Cytometry Section, I am leading our transition from 8-color to 12-color clinical flow cytometry. This will enable more detailed immunophenotypic characterization while reducing the number of tubes required and conserving limited patient specimens. We are also implementing the BD FACSDuet automation platform to reduce manual processing for our laboratory staff. In parallel, I am helping to modernize our laboratory information system for flow cytometry, designing workflows that make diagnostic reports easier for pathologists to generate and clinicians to interpret.

Implementing innovation also depends on investing in the people and laboratory infrastructure that support it. During prolonged staffing shortages and budgetary constraints, I assumed additional clinical responsibilities to maintain continuity of patient care. I also worked to strengthen the operational systems supporting our laboratory. As co-leader of our Department of Laboratory Medicine Leadership Retreat, I helped advocate for administrative and information technology resources that reduce unnecessary administrative burden and allow laboratory professionals to focus on high-value clinical work. Nationally, I was selected to participate in the American Society of Hematology Advocacy Leadership Institute, where I advocated for biomedical research, laboratory workforce development, and patient access to specialized diagnostic testing. This experience reinforced that innovation extends beyond the laboratory and requires advocacy at the national level.

Equally important is closing the gap between scientific discovery and everyday diagnostic practice. Working at the NIH Clinical Center, I routinely encounter rare diseases and emerging therapies that many hematopathologists may encounter only a few times in their careers. Through peer-reviewed publications, invited lectures, and educational resources, including AJCP’s How I Diagnose series and Blood’s Blood Work, I translate these experiences into practical diagnostic guidance that other pathologists can immediately apply. Examples include recognising adenosine deaminase 2 deficiency masquerading as Diamond–Blackfan anaemia, which later informed an AJCP How I Diagnose article on germline predisposition syndromes. Another involved reporting a diagnostically challenging lineage-switch case after CAR T-cell therapy, highlighting the importance of integrating morphology, flow cytometry, and molecular diagnostics.

By sharing my experiences through accessible educational resources, I hope to help pathologists avoid diagnostic pitfalls, recognize emerging entities more confidently, and ultimately strengthen patient care. Innovation improves patient care when laboratories can implement it, clinicians can use it, and pathologists can confidently apply it in practice. Closing that gap is how I hope to advance laboratory medicine.