There is an important distinction that is often overlooked: digital pathology and the digitisation of the histopathology service are not the same thing. The former refers to the replacement of the microscope with high-resolution digital images for diagnostic purposes. The latter encompasses the entire process: from the moment the sample is received until the report reaches the requesting clinician.
When a pathologist sits down at their screen to review a case, they need much more than just the scanned image of the slide. That image is the end result of a chain of processes that includes sample reception, paraffin embedding, sectioning, staining, scanning and technical validation. Any issue in that chain affects the diagnosis.
In order for the pathologist to make a confident diagnosis, they need access, within the same environment, to:
All this information is managed by the LIS. Without an integrated information system offering full traceability, the pathologist has the image but not the context. And a histopathological diagnosis without context is an incomplete diagnosis.
The digital pathology projects currently being rolled out in regional communities and hospital networks have recognised this: the modernisation of the LIS and the introduction of the scanner go hand in hand. This is no coincidence. The fact is, they cannot function separately.
AI tools that analyse histological images require structured data to function effectively. The LIS provides this structure: sample type, previous diagnosis, stain used, protocol applied. Without this layer of information, the algorithms operate without clinical context, which limits their diagnostic utility.
A repository of digitised cases with structured data enables cross-searches by diagnosis, morphology, technique, centre or time period. This has immediate value for day-to-day clinical practice, as well as for research and teaching.
From the electronic request generated in the clinical system to the publication of the report in the patient’s record, the LIS manages every step of the process. This eliminates paper-based interruptions, reduces transcription errors and ensures that every action is logged with the user, date and time.
The LIS maintains a complete record of all containers associated with the sample, all actions carried out on it and all equipment involved in the process. When the pathologist views the image, they know exactly what has happened to that tissue since it arrived at the laboratory.
The standardisation of diagnosis through synoptic protocols improves the quality of the report and facilitates the comparison of data between cases. It also forms the basis for any retrospective analysis and for integration with artificial intelligence tools.
A LIS with a multisite architecture enables several hospitals to share cases, distribute the workload and maintain traceability between different locations. This is particularly useful in digital pathology networks where a single pathologist can review cases from multiple sites from a single workstation.
Not all information systems are suited to operate in a digital pathology environment. When evaluating a LIS for this context, it is advisable to check that it covers, as a minimum:
Digital pathology changes where the diagnosis is made, but it does not eliminate any steps from the preceding process. Diagnostic value continues to depend on the quality of the specimen, the correct application of technical protocols and the availability of complete clinical information at the time of reading.
The LIS is the infrastructure that ensures all of this is available, organised and traceable. A digital pathology project that does not take the information system into account from the outset is not digitising the service: it is merely replacing the microscope with a screen.
International publications — hospital experiences
International organisations
