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Patients in need of a definitive diagnosis for a range of diseases typically have two experts on the case: the clinician they visit in the office and the one they never meet. The behind-the-scenes doctor is called a pathologist, and the name—derived from ancient Greek words meaning “the study of suffering”—suggests the gravity of the role. As medical specialists who examine and analyze fluids, tissues, or organs drawn from the patient’s body to identify changes and unusual features, pathologists support every aspect of medical care through their expertise in the microscopic dimensions of disease. Their findings not only guide clinicians throughout the course of treatment but also provide valuable second opinions that validate preliminary diagnoses.

The at has played a pioneering role since its inception. In 1881, William Welch, MD, was appointed professor of pathologic anatomy and general pathology, the first full-time appointment of its kind in the United States. With Edward Janeway, MD, Dr. Welch established the first laboratory for the purpose of studying the cause and pathology of many diseases and for teaching the use of the microscope. Lewis Thomas, MD, who became chair of the department in 1954, shaped its progressive research in the 20th century. Now the department is taking the lead once again. Leveraging the power of technology and artificial intelligence (AI), it has launched the Digital Pathology Program, which promises to transform the method of diagnosing disease.

Since the dawn of the field, pathologists have peered through a microscope at a glass slide containing a thin layer of biopsied tissue embedded in wax, stained with dye, and illuminated, enabling them to discern its features and abnormalities. However, digitized images are now equivalent to or better than those produced on a glass slide, making this transition possible, notes Syed T. Hoda, MD, director of digital pathology and of bone and soft tissue pathology.

Historically, slides have been delivered to pathologists by hand. Now, digitized images can reach these highly specialized experts in real time, equalizing the expertise patients have access to and ensuring the same standard of care across all our campuses. With state-of-the art scanners, up to 60 glass slides per hour can be digitized at a level of magnification equivalent to 40 times their size, resulting in sharp, high-resolution images on digital screens within minutes. “The previous method of retrieving glass slides from storage and transporting them to a pathologist off-site could delay clinical decisions by hours or even days,” notes Dr. Hoda. “For a patient eager for answers, that wait can feel like an eternity.”

The ongoing enterprise-wide conversion offers a host of additional benefits: unprecedented clarity for viewing samples, no risks associated with the storage of slides or degradation of tissue, enhanced collaboration among clinical colleagues, and improved workload efficiency for the more than 220,000 cases studied annually by �����о��� Langone Health’s 85 clinical pathologists.

“Only a handful of large academic medical centers in the United States are using digital pathology, and most have incomplete adoption,” notes Dr. Hoda. “We are one of the first health systems to fully embrace it, with compete adoption expected by the end of 2025.”

Digitizing pathology images opens fresh possibilities for the art and science of disease detection by laying the groundwork for AI-assisted diagnostics. “This program will diversify our diagnostic toolbox,” explains Sean Hacking, MD, director of digital pathology research. “Digital images will help power the AI models we are building to identify cancer and other diseases at the earliest stage, which can have a huge impact on treatment options.”

Digital pathology’s emergence comes at a crucial time for healthcare. Amid skyrocketing rates of disease, our nation faces a significant shortage of pathologists. “By leveraging the power of AI, �����о��� Langone is igniting a practice shift that could alleviate a looming healthcare bottleneck,” explains Nader Mherabi, executive vice president and vice dean, chief digital and information officer.

Pathologists will benefit as well, says Joan F. Cangiarella, MD, the Elaine Langone Professor of Pathology, vice chair of clinical operations in the Department of Pathology, and senior associate dean for education, faculty, and academic affairs. “With digital pathology, we can perform this work at a much higher level, allowing us to further elevate the exceptional care we already provide,” she says. The shift away from microscopes even creates new job opportunities, with �����о��� Langone in the process of hiring 24 digital pathology coordinators. “This technology will even allow pathologists to work remotely,” adds Dr. Hoda. “It’s not often that we get to reimagine and rethink an entire specialty.”