Samsung Medical Center(SMC)’s recent introduction of a digital pathology solution, made by Infinitt Healthcare, has drawn attention in the medical community.

Pathologists’ workload has recently increased due to the growing elderly population and cancer patients. However, the number of residents who choose to become a pathologist is decreasing, which can delay the pathologic diagnosis and negatively affect subsequent treatments and operations. Doctors’ avoiding the pathology department affects not only patient care but also public health. Samsung Medical Center chose digital pathology as the solution to this problem.

Digital pathology refers to the digitization of all workflows in the pathology department. Physicians acquire a digital image of glass slides containing the specimens through a scanner. Then, they can use it for diagnosis, manage the data, and share and analyze it. Traditionally, doctors looked at a glass slide with a microscope. In a digital pathology environment, a doctor sits in front of the monitor to diagnose a disease with digital images. For second-line consultations and cooperative patient care, they share digital files without the need to exchange glass slides.

SMC’s Pathology Department has collaborated with Infinitt Healthcare to operate the company’s digital pathology solution.

Does digital pathology really help pathology diagnosis?

Doctors at the SMC’s Pathology Department said digital pathology was a necessary change and required policy support and people’s recognition, at a news conference hosted by Infinitt Healthcare on Thursday.

Speakers for the conference included SMC’s Pathology Department Professors Jang Kee-taek, Song Sang-yong, and Cho Jun-hun, SMC’s Information and Strategy Division Manager Lee Jean-hyoung and Infinitt Healthcare CEO Kim Dong-wuk.

Professor Cho said the most significant change after the introduction of the digital pathology solution was the storage function of slides.

“This is the most useful part. In diagnosis, reviewing the past slides is very important. As storage is easy and systematically managed, this review process has become very fast and convenient. As we accumulate more data, it’s going to become even more convenient,” Cho said.

However, using the digital pathology in diagnosis is being tested only in several cases, and it will be used more broadly in the future, he added.

Cho went on to say that the digital pathology solution has great advantages for diagnosis, storage, academic and educational purposes. He predicted that it would raise the diagnostic accuracy significantly and replace or supplement glass slides in the long term, saving space and labor. He also emphasized that it would shorten the diagnostic time and become more useful for academics and education with more accumulated data accumulated.

Cho said there was yet any case where digital pathology helped detect a missing disease in analog diagnosis.

However, a digital scanner that contains Invinitt Healthcare’s program allows physicians to look broader magnifications under a microscope, whereas human eyes can only see magnifications at pre-set numbers such as 400 times, 50 times, and 10 times.

“So, the digital scanner can allow a physician to detect something that was not detected on glass slides,” Cho said.

Despite the strength of the digital pathology solution, Cho noted that it could not replace glass slides.

Professor Jang said, “Under the current law, hospitals must store slides for five years. Even if they have digital files, they have to store glass slides.” “In the long term, we will make efforts to help revise the law so that we won’t have to store glass slides if we have digital files.”

Storing glass slides is a headache not only for SMC but for other large hospitals. Major university hospitals are known to be pushing for the introduction of a digital pathology solution, too, by discussing with several companies including Infinitt Healthcare.

Under this situation, it is important to standardize related data, an SMC official said.

Lee Jean-hyoung, manager of the Information and Strategy Division at SMC, said the digital pathology allows doctors to see images of slides anywhere, anytime, as long as they have a computer.

“The reason the Radiology Department introduced a picture archiving and communication system (PACS) was to allow anyone to see medical images. If certain images are accessible only by a manufacturer, doctors have to use a particular viewer to see those data,” Lee said. “We need a technology that allows doctors to see images through a standardized format, regardless of the brand of the scanner.”

Professor Song said SMC chose Infinitt Healthcare’s service because it was a local firm.

“In the early stage of digital pathology service, almost all products can cause a bug or an error. As the company is based in Korea, we can communicate with the firm smoothly and the company quickly responds to the user’s demands,” he said.

Introducing digital pathology can help the hospital utilize artificial intelligence (AI) in pathology.

However, experts said AI would not easily replace human doctors.

Song predicted that it would take some time until AI machines could become like human pathologists.

However, AI could replace pathologists’ time-consuming and bothersome work such as counting or proportioning the smallest findings across the slides, he said.

The Korean Society of Pathologists is voicing for reimbursement in pathology, calling on the government to keep pace with changes in the pathology sector.

Jang said, in the past, it was easy to persuade the government to grant insurance coverage for images in PACS because we could save costs by replacing X-ray films with PACS image digital files.

However, PACS in pathology requires the making of slides first, which makes it hard to reduce costs.

“The government would find it difficult to see a cost reduction. They ask us what kind of benefits patients will enjoy if we introduce this. But in terms of cost, we are at a disadvantage, compared to images using PACS,” he said.