A.I. Elevating The Role Of Pathologists – Interview Dr. Monica Santamaria-fries, Digital Transformation Officer At Proscia

Dear medical futurists,

You know how I think about artificial intelligence and its role in the future of healthcare: I’m a big admirer of the technology and even took up chess to understand it better. So you probably understand why I liked when Proscia’s digital transformation officer, Monica Santamaria-Fries mentioned that “AI has the potential to unlock insights that remain hidden to the human eye, and these insights could help to advance the way we understand and treat disease, driving accuracy in diagnosis, and establishing prognosis and personalized therapies for patients.” 

And while we tend to think pathologists spend their time looking into microscopes, companies like Proscia provide them with A.I. solutions leading to more efficiency, quality and productivity.

How can A.I. elevate the role of pathologists in cancer care?

Let me start out by saying that I really like the way you phrased this question. When it comes to AI in pathology, it really is about elevating the role of the pathologist.

Right now, we’re largely seeing this play out in terms of AI-enabled workflow applications, or applications that support tasks related to the processes that the pathologist carries out each day. Consider that when the pathologist starts her day, she likely receives a set of cases that she knows very little about. This means that she won’t know which cases will require more time to diagnose or even if she has the expertise required to make the most informed evaluation.

AI-enabled workflow solutions solve many of these challenges. Such applications enable pathologists to focus more of their time on critical tasks, such as evaluating challenging cases so that they can add value where it matters most.

Pathology was disrupted by COVID-19 overnight – where is the field heading?

The standard of care has typically centred around pathologists assessing tissue biopsies under the microscope in physical laboratory spaces. COVID has obviously posed challenges to this practice in light of social distancing requirements and health concerns for an aging pathologist population.

Digital pathology, which captures high-resolution images of tissue biopsies, has provided a practical solution for laboratories to operate remotely. It enables pathologists to view images on-demand as well as share them with colleagues who may also be working from home. For this reason, along with regulatory relaxation that has expanded access to digital pathology devices, we’ve seen a surge in demand for adoption over the past year or so as we illustrate in our 2020 Digital Pathology Annual Report.

Making the shift to digital pathology is the first step in laying the foundation for AI since AI applications depend on the data contained in digitized images. As healthcare professionals are increasingly vaccinated, I believe we are settling into the new normal so-to-speak, and digital pathology will continue to play a growing role in the way that laboratories and pathologists operate. 

Quite simply, laboratories that have started to realize the benefits of digital pathology will continue down this path, and the momentum will continue to snowball as other laboratories seek to benefit as well. I also see this accelerating adoption of AI and the unearthing of the unprecedented value that it can provide.

What is Proscia's approach to the industry?

We see laboratories adopting an increasingly sophisticated ecosystem of hardware and software solutions to enable their pathology practices. These solutions include scanners to create digitized images; a digital pathology platform, like Proscia’s Concentriq, for viewing, managing, and analyzing their images; laboratory information systems; and now AI applications - all from a variety of providers to best meet their needs. 

We believe in an open approach centered around interoperability to give laboratories the flexibility to build out a connected ecosystem that works for them today and in the future, and this is what we deliver in Concentriq.

Our open approach is resonating in the market; LabPON, the first laboratory in the world to reach 100% digital pathology diagnosis, recently transitioned to Concentriq to gain the interoperability it needed to continue scaling its practice.

We also design our solutions for pathologists, and as a pathologist myself, this is something I’m especially passionate about. Since pathologists are the primary users of digital pathology software, it is critical to hear their voice and deliver offerings that address their needs, helping them to achieve what matters most to them in addition to benefiting the broader laboratory operations.

Where does the FDA stand with remote digital pathology and its devices? Were there any advancements from the authority over the past 12 months?

In April 2020, the FDA issued emergency guidance aimed at expanding the availability of remote digital pathology devices. The FDA recognized that digital pathology may help laboratories to continue serving patients and sought to expand access to devices that are intended for use in the remote reviewing and reporting of digital pathology slides. Before the pandemic, these devices required 510(k) clearance for primary diagnosis, and only 3 systems had been cleared since 2017.

While this guidance applies to the period during the pandemic, the FDA is considering making many digital pathology devices exempt from 510(k) clearance after COVID-19 comes to an end. This decision is currently open for public comment, and it remains to be seen what will happen.

What is Proscia’s platform and how does that operate - what are its key benefits during a pandemic, and will these benefits be of use and stay with us after COVID-19 has gone?

Proscia offers a core digital pathology solution called Concentriq® Dx, which provides enterprise functionality for helping laboratories carry out their routine pathology operations, including viewing, managing, and analyzing images. Specific to operating during the pandemic, the key benefits of Concentriq Dx relate to enabling pathologists to work remotely so that laboratories can continue to provide patients with timely diagnosis. In doing so, Concentriq Dx is also giving pathologists increasing work-life balance, which contributes to their overall satisfaction.

The Concentriq platform serves as a launchpad for AI applications, including a suite of applications that we’re building as well as other third-party applications. This goes back to our open approach. While different laboratories are taking different approaches to deploy AI, we believe that the only way laboratories will truly scale their AI adoption is by leveraging an AI-enabled platform. This way, they can seamlessly deploy AI into their routine operations and realize the true promise that it brings.

Finally, I’d like to spend a minute on the macro-level view of pathology. The pathologist workforce is steadily decreasing as biopsy volume continues to rise, leading to a 42% increase in cancer cases per pathologist between 2007 and 2017. This is compounded by factors like older pathologist demographics, less interest in training, and increased case complexity. So, when we talk about the benefits of digital pathology, we should also consider how the technology is benefiting the industry as a whole.

And so, here we are in the midst of an incredibly exciting time for pathology. I’m looking forward to seeing how this all plays out.

So am I!

Take care,

Berci   

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