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If You Think Digital Pathology Is Too Expensive, Think Twice

By Bill Muchow

The human impact of delaying the cancer patient's journey

Catching cancer early saves lives. This is the adage that at-risk patients are constantly reminded of, as they consult doctors and keep up with routine screenings, dutifully reporting early signs of out-of-the-ordinary changes.

Yet, for patients and their families, the disconnect between needing to move quickly and navigating the delays between diagnosis and treatment is all too real, punctuated by a state of limbo where needless waiting is the norm.

Take it from me: I chose a career in digital pathology after both of my parents were diagnosed with cancer within a year of each other. In my mother’s case, it was two weeks and one day from suspicion to diagnosis; in my father’s case, it was slightly better—one week and three days.

I can tell you from my own first-hand experience that this delay is torturous. Your mind races, you barely sleep, you barely eat, and many prayers are said. Your life is put on hold as you wait to learn more. The average wait time for highly accurate, conclusive findings from a biopsy is often a week or more (and can be much longer if secondary consultations are needed).

It doesn’t have to be this way. We can and should do better. Today, we live in a world where we expect on-demand technology to deliver instantaneous results (thanks, Netflix), but sadly, this is not the reality for patients (and patient advocates and caregivers) who are involved in cancer diagnosis and treatment.

When we first learned of my mother's diagnosis, we expected treatment to begin immediately. It's cancer after all! Every day that slipped by without a plan for treatment felt like a wasted opportunity.

The unfortunate reality is that we’ve actually added more time to this endless process in recent years. This study found that the median TTI (time to treatment initiation) has increased from 21 to 29 days. More troubling, the risk of mortality has also increased because of this delay—ranging from 1.2 to 3.2% per week—in curative settings such as early-stage breast, lung, renal and pancreas cancer.

Early detection saves lives and money.

It's important to distinguish the critical importance of early detection from delays in diagnosis and treatment. Early detection does save lives and money. We know that reducing time to diagnosis increases the chance that the case at hand is less complex to diagnose and manage. Available treatment options tend to be more varied, outcomes can be more favorable, and patient stress is often lessened. Cancer prevention and early detection remain central to the American Cancer Society’s mission to save lives, with an estimated 42% of cancer cases and 45% of cancer deaths in the US attributed to potentially modifiable risk factors. Increasing cancer screening tests and evidence-based interventions can prevent thousands of additional cancer cases and deaths each year.

Early detection also saves money. The earlier that cancer is caught, the greater the likelihood that treatment will be more routine and cheaper, requiring fewer rounds and less complex surgery. In fact, studies in high-income countries have shown that patients who are diagnosed with early-stage cancer have treatment costs that are two to four times less expensive than patients diagnosed with advanced-stage cancer. One U.S. study estimates national cost savings from early diagnosis at $26 billion per year.

Digital pathology is the missing link.

Given that cost savings (and lives saved) from early detection can be tremendous, the ROI in digital pathology becomes indisputable. (For those who would like to dive deeper into such considerations, I recommend checking out our interactive online ROI calculator and its accompanying white paper.)

Digital pathology is the key to accelerating diagnosis timeframes, reducing costs and increasing patient care—ultimately saving lives in the process. By transitioning workflows from analog to digital, key efficiencies are achieved: from the removal of direct (and opportunity) costs associated with the clinician needing to be in possession of the glass; quick access to second opinions; the ability to outsource work during peak periods, holidays, pandemics; to effective assignment of allocations based on capacity and specialization of the end pathologist. Gone are the plethora of micro-inefficiencies associated with analog processes, with results delivered in a couple of days versus a couple of weeks.

Further, digital pathology offers digital-only advantages in the form of AI that can assist with diagnosis, prognosis and prediction to better inform the care team. For example, AI can be used to automatically select regions of interest in the scanning of tissue slides, as well as in conducting analyses. This frees up pathologists to work on other tasks and to take on more cases, boosting efficiency while reducing the time and resources lost to correct mistakes.

In this age of social workplace distancing, it also empowers pathologists to review slides from anywhere in the world and collaborate on global consults, all instantaneously. Speed to treatment is critical to increasing patient satisfaction goals, which is even more important than ever in light of the ever-changing payment reform within healthcare.

Every moment matters in the patient experience.

Is digital pathology too expensive? Not if you subscribe to the belief that “every moment matters." More than simple image viewing and evaluation, digital pathology streamlines case management by exploiting advances in image digitization and solution interoperability, ensuring accelerated return of patient results. Consider the many efficiencies digital pathology brings to the lab and the overall cancer journey, and its incalculable positive impact for the patient experience and survivorship, and the argument for digitization becomes crystal clear.

As I reflect back on my parents' journey as cancer patients, I know that I would have sacrificed a lot to eliminate the lag time between suspicion and diagnosis, then again between diagnosis and treatment. Being able to significantly enhance the agency and efficacy for patients and their advocates in the cancer journey is priceless—and it's a key advantage that digital pathology is uniquely positioned to offer. Let's not wait to make every moment truly matter.

Tags: pathology, digital pathology, business case, ROI