A summary of a panel presentation held at the Digital Diagnostic Summit 2025 meeting. The panel was led by Imogen Fitt, a Principal Analyst at Signify Research, alongside panelists Giovanni Lujan, Adam Cole, and Gregory Osmond. In the quickly-evolving landscape of diagnostic medicine, the question is no longer if a lab should go digital, but how it can do so efficiently and effectively. At the Summit, we held a candid panel to examine a critical dilemma: In an era of shrinking budgets and pathologist shortages, which tools are true force multipliers, and which are merely “digital dead weight”?
ROI Surpasses Novelty
All of the panelists agreed: with limited time, money, and expertise, every tool in a digital pathology workflow must justify its existence through its Return on Investment (ROI). The goal of a digital pathology transition isn’t just to see images on a screen; it’s to improve gross margins.
As the industry faces reduced reimbursement fees and clinician shortages, practices can’t afford to waste resources on tools that fail to improve efficiencies and cost savings. Each piece of the puzzle needs to pull its weight to be considered a success.
AI: A Valuable QC Tool with Potential for More
Let’s start with the elephant in the room: AI. The transition to digital pathology is often sold through the novelty and promise of AI innovations, but how do practices’ real-world experiences compare to the expectations?
One panelist noted that a well-integrated digital workflow, coupled with diagnostic AI, has yielded a 33% increase in their capacity at baseline. However, the panel’s consensus on AI was nuanced: its value lies in safety and speed, not in replacing the diagnostic “aha!” moment.
What’s Useless: Algorithms that simply identify obvious pathology (e.g., “This is basal cell carcinoma”). A trained pathologist knows this in seconds; a computer telling them what they already know is a “speed bump.”
What’s Essential: Tools that handle the “drudge work”—things like counting cells, Gleason grading, or scanning for perineural invasion.
The Safety Net: AI excels at screening for high-priority cases (like H. Pylori) and performing retrospective Quality Assurance (QA) to catch “misses” that human nature might overlook during a long shift.
However, the experts issued a stern warning: Integration is everything. If a pathologist has to download images or navigate a “clunky” interface to use an AI tool, it will sit on the digital shelf gathering virtual dust.
Infrastructure Predicts Success
One of the most unexpected takeaways was the panel’s advice on legacy systems. They pointed out that many labs are tethered to Laboratory Information Systems (LIS) built in the 1990s, held together by aging HL7 interfaces.
“If your system is a massive pain to customize and relies on outdated tech, don’t patch it,” the panel suggested. “Rip out your LIS.” To move forward, labs need modern, cloud-based solutions and a robust IT infrastructure capable of 24/7 support. Without a seamless Image Management System (IMS), digital diagnostics, and realizing the promised benefits of your acquired tools, becomes impossible.
The “Omnipathologist” Era
As it commonly happens when discussing AI and digital tools, the question arose: “Will these advancements replace pathologists?” Our panelists were confident in dismissing the possibility as a misunderstanding of the technology’s trajectory. Instead, they agreed, AI won’t take the job of a pathologist, but a pathologist who uses AI will almost certainly replace one who doesn’t.
The future role of the pathologist was described as an “omnipathologist diagnostician.” This new kind of physician integrates morphological data with molecular and transcriptomic insights. While predictive AI (which can suggest treatment paths based on slide morphology) is the “holy grail,” current regulatory barriers often prevent pathologists from ordering these tests directly—a hurdle that must be cleared to fully realize the value of the digital shift.
Collaboration Moves the Needle
Beyond the math and the code, digital pathology’s greatest gift is connection. It removes the physical barriers of the multi-head microscope, allowing for real-time subspecialty consultation and a higher level of practice. By focusing on interoperable tools and modernizing systems, labs can ensure their digital adoption is a bridge to the future.
For more information like this, subscribe to our free bi-annual Digital Diagnostic Digest by filling out the form below:
