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The COVID-19 pandemic has dramatically confirmed the value of pathology. For a relatively small cost, the practice of pathology provides a wide-reaching, large return on investment and is the foundation for diagnostic medicine. Ideally, this realization should lead to the recognition that investments in a strong Anatomic Pathology Laboratory Information System (APLIS) are essential for best patient care.

Because of historically tight budgets, some pathology groups continue to use outdated legacy systems that do not offer the future-focused functionality needed to support today’s pathology laboratories. Upgrading those older systems can mean a large jump in technology to catch up with modern standards. As a result, some pathology labs are using outdated systems that are not future-focused and do not have the functionality to effectively support today’s pathology requirements. When a pathology lab has held onto a legacy system and has not invested in that system’s growth over time, a big jump in technology may be required to catch up.

Pathology Lab Challenges & Changes
Healthcare systems, including pathology, face the challenge of balancing strained budgets with their ongoing needs. Pathology groups continue to work through consolidation and crisis-level staffing concerns while also handling a boom in molecular testing because of COVID-19. To address these challenges, and to manage the growing concern over cybersecurity, many groups have chosen to shift to cloud-based systems.

Monumental Staffing Problems Continue
One of the biggest challenges that pathology laboratories currently face is a monumental staffing shortage. The entire laboratory industry has faced staffing shortages for years and there is no relief in sight. COVID-19 put an extreme amount of pressure on many laboratories, exacerbating the staffing shortage. The Bureau of Labor Statistics projects the demand for clinical laboratory professionals will grow 7% from 2019 to 2029, which is nearly double the average growth rate for all other occupations. While all areas of the laboratory are dealing with staffing shortages, a crisis-level shortage of histotechnologists is straining the pathology industry.

Pandemic Boosts Molecular Testing
The COVID-19 pandemic has also been a catalyst for the growth of molecular testing, which is shifting the testing menus of many pathology laboratories. Last year, many labs invested in new molecular technologies to address COVID-19 testing. These analyzers are now also being used for infectious disease testing, cancer diagnostics, women’s heath, and more. Forward-focused pathology labs have a combination of anatomic pathology instrumentation, molecular analyzers, and digital pathology tools, enabling flexibility and future growth.

Cybersecurity Concerns Shift APLISs to the Cloud
Because AP labs are quite complex, security is another top concern. In the past, healthcare organizations shied away from cloud-hosted systems because of patient confidentiality and security concerns. However, it is becoming widely acknowledged that cloud systems offer increased security and reduce the strain on internal information technology (IT) staff. Thus, many pathology groups are have already invested in a cloud solution or have plans to transition.

What Pathologists Labs Want in an APLIS
The overarching goal of the pathologist is to get accurate diagnostic information to the provider to allow for timely patient care. The pathologist needs to be able to securely access comprehensive results from all disciplines (e.g., clinical, pathology, molecular) to formulate the pathology report and deliver results back to the caregiver as fast as possible. Fragmented, siloed data slows this process. The user interface (UI) of an APLIS needs to be fast, intuitive, and easy for the pathologist, fitting into the natural flow of work. The expectation is that the APLIS UI can minimize clicks with keyboard shortcuts and voice dictation. Having an outdated legacy APLIS only adds to the struggle. The overall goal is for the APLIS to take away the pain of looking through multiple systems and struggling to create a consolidated report.

An Enterprise APLIS Brings Efficiencies That Help Mitigate the Staffing Shortage
A sophisticated, enterprise APLIS with a single database holding clinical, anatomic pathology, and molecular data allows pathologists to access the data they need to create consolidated reports, making their jobs easier. The overall workflow efficiency boost and improved processes managed by the APLIS can reduce errors and provide standardized reports, including guidance for synoptic and biomarker reporting. An innovative, forward-focused APLIS can help mitigate the pressure on pathology laboratories by report consolidation, workflow enhancement, patient safety features, and an intuitive user interface.

Cloud Benefits for Pathology
A single-platform, cloud-based APLIS also provides a consolidated IT footprint and allows the IT team to focus their efforts and time elsewhere. The cloud-based APLIS removes worry over security because those concerns are being addressed by the vendor.

Looking Forward – AI/ML
With the support of cloud computing, it is becoming recognized that Artificial Intelligence/Machine Learning (AI/ML) tools applied to digital pathology can provide prognostic or diagnostic algorithms that are extremely valuable for the pathologist. For example, computer-derived algorithms have been successfully used to help assess breast cancer slides and predict which patients will progress to advanced disease, and AI/ML systems are helping pathologists differentiate between benign and malignant prostate tumors.1

Interoperability & APIs
Today’s healthcare system is pushing toward interoperability, where patient data is securely accessible when and where it is needed across the healthcare community. The future of healthcare integration is shifting away from HL7 interfaces to Application Programming Interfaces (APIs), opening the door for improved interoperability and providing tool sets that allow laboratories to access and extract data and to manage their own interfacing.

Pathology Labs Need a Flexible, Innovative, Future-focused APLIS Partner
There is a continually increasing need for pathology services. Ideally, addressing the pandemic has helped the public and healthcare executives understand the value and importance of pathology that it is a small overall investment with a tremendous value.  This realization should lead to a greater recognition and the budget it deserves to enable improvements in patient data handling and stronger overall pathology departments.

It is evident that pathology labs need to be proactive and prepare to embrace the exciting new technologies that are becoming available and more affordable. Today’s challenges and changes cannot be faced with an outdated, legacy APLIS. Forward-thinking pathology groups are finding vendor partners that have solutions and services to help mitigate the staffing crisis and implement products that make their day-to-day jobs more efficient and help improve patient care.


  1. Parana, A.V. Next generation diagnostic pathology: Use of digital pathology and artificial intelligence tools to augment a pathological diagnosis. Diagn Pathol 14, 138 (2019). https://doi.org/10.1186/s13000-019-0921-2