Hospital for Special Surgery (HSS), the world’s leading academic medical center specializing in orthopedics, rheumatology, and related disciplines, has become the first facility in the country to launch a cutting-edge technology for the digitization of pathology slides allowing pathologists to use digital images as primary means of diagnosis.
The system, called the Sectra Digital Pathology Solution, lets HSS pathologists scan and upload slides into a single repository where others in the care team — from orthopedic surgeons and radiologists to rheumatologists and endocrinologists — can view them, along with radiologic images that also are housed in the system. This facilitates access for specialists from across HSS to share and discuss tissue samples in real time, making care more efficient and improving clinicians’ ability to diagnose and treat their patients. Additionally, HSS clinicians and others in the care team can review the digital slides individually, simultaneously or slides shared by other hospitals to consult on complex cases.
“HSS is the first hospital in the United States to have successfully integrated a high-resolution digital scanner [Leica] with the pathology Laboratory Information System [Epic/Beaker] and the enterprise-wide PACS [Sectra] in a way that allows pathologists to use digital images for primary diagnosis,” said Thomas W. Bauer, MD, PhD, pathologist-in-chief at HSS, who led the digital pathology initiative.
Allowing surgeons, radiologists, and other physicians to view high-resolution digital images of scanned microscope slides can significantly improve patient care, Dr. Bauer said. “Access to digital pathology images, side by side with radiology images on the same enterprise-wide PACS, enables correlation between different types of studies and promotes efficient discussion about complicated cases.”
In addition, instantly viewing digital images from previous procedures will be much easier than retrieving old microscope slides from long-term storage for re-review, he added.
“The implications of the move to digital pathology are significant for patients everywhere,” Dr. Bauer said. For example, because HSS pathologists are experts in musculoskeletal pathology, they frequently receive cases for consultation from other hospitals.
“Receiving digital images electronically from hospitals with their own scanners will facilitate consultative review, and has the potential to greatly reduce turnaround time,” he added.
“Digital pathology is the natural next step in the digital transformation of healthcare,” said Douglas N. Mintz, MD, a radiologist at HSS who specializes in musculoskeletal imaging and who was instrumental in developing the platform with Dr. Bauer. “We can compare what we see on an image with what was seen on biopsy. It also facilitates the correlation between radiology and pathology, which is particularly important in the diagnosis and treatment of musculoskeletal neoplasms.”
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“The scanned images are extremely high quality and, when used in combination with the Leica scanner and Sectra viewer, are considered by the FDA to be equivalent to conventional microscopy for making a primary diagnosis,” explained Dr. Bauer.
HSS, ranked #1 in the world for Orthopedics by Newsweek and has been ranked #1 in the United States for orthopedics for 11 consecutive years by U.S. News & World Report, began its digital pathology initiative in 2017, and started working with Sectra technology in 2018, when it was still in the development phase. Initially, the goal was to use the system in a limited fashion, for particularly challenging cases in which clinicians had questions about pathology reports. But the COVID-19 pandemic prompted the FDA to grant the company emergency use authorization for its imaging platform, allowing HSS to speed up its transition to digital pathology.
“It is gratifying to see our vision of Integrated Diagnostics come to fruition after a long software development and integration journey,” said Inderpal Kohli, assistant vice president, IT Clinical Applications at HSS. In addition to other benefits, the solution offers HSS clinicians a familiar user interface and workflows, enabling ease of use and broader adoption across the enterprise.
Beyond patient care, digital pathology will also have an immediate impact on student and resident education, both at HSS, where the technology already is being used to help trainees, and elsewhere.
“We and other hospitals anticipate incorporating digital pathology into a variety of educational conferences available online, in which residents and fellows learn from more senior faculty by reviewing digital images,” Dr. Bauer said. “As other hospitals convert their systems to digital imaging, they will be able to better take advantage of the expertise of the faculty at HSS and other centers of excellence, thereby promoting physician education and improving the care of patients around the world.”