Shaping the Digital Blueprint

Shaping the Digital Blueprint
15 April 2024
In March 2024, RCPath hosted an NHS England event to discuss the digital progress made in pathology and to consider areas for future improvement.

The in-person event, held on 22nd March at the Royal College of Pathologists (RCPath) in London, was additionally supported by the IBMS and the Association of Laboratory Medicine (ALM).

Widely attended by pathology network leaders, regional leaders and experts in technology, the event successfully created a forum for discussing the progress made to date, the existing barriers to adoption of technology in pathology, and priorities for future investment.

As well as organising speaker presentations, event hosts held guided workshops, allowing participants to freely discuss the current state of digital pathology and highlight opportunities for improvement.


Technology Enables Transformation in Pathology

In 2020, the NHS began to invest in the digital capabilities of Pathology networks across the country.

Pathology plays a pivotal role in most diagnoses within the NHS, with nearly 1.2 billion investigations and tests conducted annually. NHS pathology services operate on a vast scale, and there is a real opportunity to transform pathology through technology.

By mobilising and enabling leaders across the 27 pathology networks and all seven regions, there is potential to drive meaningful change and identify barriers for delivery in the future.

In recent years, NHS providers have been bringing services together into more resilient and productive networks, with the aim to provide patients with better access to investigations.

Right now, decisions are about to be made on the next round of investment into the digital capabilities of Pathology networks. The overall objective for networks is to achieve a Maturing level of capability in IT & Digital by March 2025, so now is the right time to agree a model for future collaboration on a long-term approach.

Debra Padgett, Past President of the IBMS, drove this point home in her speech at the event, explaining: “We have the responsibility to spend this money wisely, to challenge systems, and to think differently about our services.”


The Difference Investment Has Made

Speaking on the current digital Pathology landscape, Rob Dale (Senior Programme Manager, NHS England), described how, through implementation of digital Pathology reporting systems, over 50% of services are said to have moved to be reporting digitally already. Prior to investment, there was a notably lower maturity for IT & Digital across England’s pathology networks.

Exploring this further, Dr Sjors Koppes (Heck & Neck Pathologist, Erasmus University Medical Centre, Rotterdam) provided a case study analysis for digital pathology in the Netherlands. In fact, the Netherlands is known to have the largest national archive of digital pathology reports. This has meant that slide retrieval time, for instance, has been reduced to zero, with the whole archive being instantly accessible. With the digitisation of reports, it has also been possible to carry out deep learning through methods such as image clustering.

Other case studies presented on the day revealed further benefits of investment, such as consolidated LIMS for transforming entire IT systems of pathology services. Speaking on this particular case study, Matt Connell (Director of Digital, Data & IT at North West London Pathology) highlighted some vital benefits, including reduced local variations between IT systems and enhanced decision-making. Through more consistency across systems like LIMS and other analytical platforms, more consistent results and better patient care is being provided.


Remaining Barriers and Priorities for Future Investment

Two guided workshop sessions at the end of the day enabled participants to discuss, firstly, the remaining barriers to technology adoption in pathology, and secondly, some priority areas for future technology investment.

A total of nine areas were presented to participants across the pathology pathway, from patient consultation and request to patient consultation and result. Areas such as archiving were identified as potential barriers to technology adoption, with some attendees pointing to the lack and cost of storage space as issues, as well as the need to improve electronic tracking. Other participants spoke about the challenges associated with sample tracking, repeat requesting, the general speed of technology and outdated systems.

Following this, attendees were invited to vote for their individual top 3 priority areas for potential investment. Event hosts have requested people to consider the potential impact that resolving a given problem would have on the service, what would indicate success, and what the risks might be. Participant feedback will be summarised into a report produced by event hosts near the end of the month.


A Proposal for Developing a National Blueprint

To round up the event, Rob Dale took the lead again by expressing the need for a blueprint to provide a detailed model for the deployment of technology in Pathology.

In his presentation, Rob summarised NHS England’s vision for transforming diagnostic services, including providing equal access to services for patients across the country, ensuring clinicians can be best supported by AI, and maintaining operations through simpler pathways and capacity and efficiency insight.

He described the ‘five lenses of the vision’; investing in compatible systems, improving data storage, building a national sharing model to transfer capabilities between networks, harmonising practice around a patient, and enabling AI to support decision-making and automation of processes.

“We want this event to be the first of many conversations to build on the work of the digital vision across pathology and other areas of diagnostics. We need collaboration to translate this high-level thinking into a coherent strategy to enable the transformation of pathology services,” said Jane Mills (Deputy Director of Pathology, NHS England).


The IBMS would like to extend a huge thank you to all participants, as well as colleagues from RCPath and ALM for their help in running this event.

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