Pathology IT future ‘more complex than assumed’

“Only by making managed pathology networks adaptive can pathology services become agile enough to respond effectively to increasing future demand for change,” argues the paper written by Donald Saum of Sysmed and writer, William Payne.

According to the authors, this “adaptive approach” to managed pathology networks will create a pathology information infrastructure that is inherently designed from the outset to be responsive to change – whether that change emerges from developments in the national IT infrastructure, changes in health provision and public demand, or from new pathology technologies and practices.

“It requires an information infrastructure that is so flexible, scalable and open that development and change is always cost-effective, incorporating best-of-breed functionality with no hidden overheads or barriers to change.

“This approach provides managed pathology networks with a very high level of flexibility and adaptability. New services and functions can be rapidly implemented across the whole managed pathology network. The network can be reconfigured, extended or consolidated on-demand,” they say.

The authors list several reasons to justify their prediction of a very complex outlook for pathology services.  Factors at work include:

• the move from settled populations with predictable health needs to a more unsettled shifting pattern;


• more mobile global populations triggering more frequent challenges by new diseases;


• modernised healthcare delivery that demands new patterns of provision, likely to be underpinned by lightweight and mobile testing technologies;


• the prospect, on a future horizon, of genetic-based testing with one sample for many tests.

The paper points out that while there is a logical move towards the centralisation and automation of laboratories to cut costs, speed up results and reduce errors, there is pressure in the opposite direction to push pathology services delivery towards a more distributed model.

The authors say that many of these distributed technologies – near patient testing and home chronic care testing – are currently hard to justify in terms of cost against the efficiencies of large centralised operations.  However over the next ten years the cost, complexity and size of automated analytical instruments could fall sharply.

“Low cost diagnostic technologies, based on chip-embedded devices, are already making an appearance. At present, these cannot compete in terms of throughput or volume cost per test with large scale automated instruments. But they are a disruptive technology, and their rate of improvement could overtake established laboratory instruments within a decade,” say Saum and Payne.

They point to work done by Sysmed with Barts and The London NHS Trust and another large automated facility where the adaptive approach has been used.

They say both sites feature the ability to integrate a wide range of platform technologies, systems automation, telepathology, interoperability and device technologies. And both sites are able to run their systems within a centrally hosted environment, delivering exceptional levels of flexibility, scalability and cost-effectiveness to regional pathology services.

“In effect, any configuration of managed pathology network can be efficiently hosted from a central location. As new demands arise, the network can be rapidly reconfigured to accommodate changing needs,” say the authors.