By Dan Lambert, CEO of PathologyWatch, earned his MBA from Harvard Business School and has led successful ventures and company exits.
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According to a 2022 report published by Facts & Factors Research, big growth is expected in the global digital pathology market. The market was valued at $740.26 million in 2021 and is projected to burgeon to $1,738.82 million by the end of 2028. That anticipated growth represents a 13.8% CAGR increase between now and 2028.
Where pathology is the medical practice devoted to providing diagnostic information to patients and clinicians, digital pathology is a cutting-edge, image-based discipline that acquires, manages and interprets pathology data from a digitized glass slide. Dermatopathology, or the diagnosis of the skin, is one section of this field showing tremendous untapped growth potential.
There are several market forces driving the adoption of digital pathology forward. Digital pathology also continually unlocks prognostic and pharma research opportunities. Let’s examine these trends a bit more closely.
Increased Demand For Remote Work
The advent of the Covid-19 pandemic saw significant demand for remote work capability through most every industry, and pathology was no different. Not long after declaring a national emergency in the US, the Centers for Medicare and Medicaid Services (CMS) waived certain requirements for remote pathology sites. The FDA soon followed suit, noting the action was intended “to provide a policy to help expand the availability of devices for remote reviewing and reporting of scanned digital images of pathology slides.”
Where there’s demand, there’s a way—and there’s currently a huge gap between the developed and emerging worlds in regard to cancer diagnostics. Many countries outside of the US have a distinct quality-of-care deficit when it comes to technology and healthcare diagnostics. Without digital pathology, underserved populations throughout the world (including rural US) might have no way to access a specialist. I predict that remote digital pathology will eventually help leapfrog the latest technology forward by connecting individual offices with dermpath experts and algorithms throughout the world.
New CPT Codes
The College of American Pathologists (CAP) worked with the AMA CPT Editorial Board this past year to develop a series of new Category III digital pathology digitization procedure codes. The 13 new codes—0751T-0763T—went into effect on January 1.
Prior to the change, US labs used the same CPT codes to report a diagnostic read, with no distinction showing whether the diagnosis was made using digital pathology or under a microscope. Hence, reimbursement amounts were the same for both procedures.
The new codes address that issue by helping recoup some costs of running a digital pathology program. Some analysts estimate a $4-$5 per case reimbursement when these begin to be paid. I see this change providing a clear financial incentive for labs to invest in digital pathology.
Clinical Correlation
The most important factor driving digital pathology today is improved outcomes for patients. Whenever you combine the experience and different skill sets of dermatologists and dermatopathologists and improve the lines of communication between the two, the patient benefits.
Digital pathology streamlines the process by scanning the samples into digitized slides. Dermpaths can then read the case digitally. Results are returned to the dermatologist, who also has access to the digitized photos, and consultations can occur in real time between the dermatologist and dermpath. This may be the first time a patient can see their own case and receive an explanation from the dermatologist as to what is happening in the image and why a specific treatment is being recommended. What is also amazing about digital pathology is that now every case can potentially be seen by a leading global authority.
Quicker and more efficient diagnosis and communication can position the patient as the real beneficiary of digital pathology advancement. Having multiple board-certified physicians looking at a patient case and sharing notes can help provide better diagnostics and eliminate potential errors. In time, I predict that digital pathology and remote reads by experts will be the industry standard.
Single-Solution Systems
Until recently, I’ve seen most parts of the digital pathology process being handled separately. This meant one company specialized in building viewers, another developed the diagnostic algorithms and somebody else built the EMR systems that tracked each patient’s case in the originating clinic. But now a number of vendors have developed systems that connect each step into one cohesive journey. This patient-centric interdependence model is revolutionizing healthcare and is addressed at length in one of my previous articles.
The fact that a few different vendors have developed start-to-finish systems is a good thing for digital pathology. I believe this means the industry will continue shifting to support digital solutions.
Further AI Development
AI development is an ever-developing game-changer, but the initial technology investment can seem daunting when scanners can run from $250,000 to $1 million. Labor savings, however, can compensate for the upfront scanner investment.
The use of AI in medical imaging helps dermpaths promote early intervention by identifying conditions much quicker. A 2021 study at Tulane University, for example, found that AI, by analyzing tissue scans, can accurately diagnose colorectal cancer as well as or better than pathologists on their own. Additional research my company took part in also shows that AI is capable of diagnosing basal cell carcinoma at 99% AUC and other forms of skin lesions at extremely high success rates as well. The main takeaway is that AI screeners will continue to improve and help pathologists make better diagnoses, which will help make patients safer.
While AI might not replace pathologists any time soon, I do forsee pathologists using AI will replace pathologists not using AI because of the potential speed and safety improvements.
With rising numbers recognizing the advantages digital pathology provides, the future of healthcare is digital.
