Blog | 6/11/2025

Digital Pathology: Have We Finally Reached a Tipping Point?

By Arushi Agarwal, Gary Gustavsen, Nicholas Cadirov, PhD, and Gabriel Blatner

Introduction

Enthusiasm for digital pathology has fluctuated over time, rising and falling with new advances in hardware and algorithm capabilities. However, there is a new and more sustained momentum as stakeholders increasingly recognize digital pathology’s value as an enabler for companion diagnostics. 
In this post, we explore the drivers and barriers to widespread adoption (enriched with insights from pathologist surveys) and highlight the broad industry trends fueling growth. As the term “digital pathology” can have various meanings to different stakeholders, let’s begin by establishing a clear framework that encompasses all aspects of digital pathology.

Defining Digital Pathology

The digital pathology workflow starts with digitization of glass slides to create high-resolution images. These images are then stored, analyzed, and shared electronically. An ecosystem of tools and technologies form the backbone of digital pathology workflows, and includes:

  • Image Acquisition: Scanners are used to capture high-resolution digital images of slides. 
  • Image Storage: Digitized slides are organized and securely stored either in local databases or the cloud, ensuring they are readily accessible for analysis.
  • Image Interpretation
    • Viewing and Annotation: Digital images are viewed and annotated to identify regions of interest.
    • Aided Analysis: AI/algorithms are increasingly being used to interpret images and derive clinical insights, complementing human efforts.

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The digital pathology ecosystem has enhanced efficiency and enabled more streamlined workflows, leading to adoption by leading cancer centers and academic labs. However, smaller labs and hospitals are still in early stages of adoption. Why is this the case? There are various drivers and barriers that institutions are influenced by when making the decision whether to adopt digital pathology technologies.

Drivers of Digital Pathology Adoption

Several key factors have compelled institutions to embrace digital pathology, including:

  • Clinical Need: The increasing complexity of diagnostic tests and the need for precise identification of patient cohorts for targeted therapies are driving the adoption of digital pathology. Traditional diagnostic methods are simply insufficient for some new drug modalities in the pipeline, which require more granular diagnostic measures.
  • Technological Advancements: The development of more sophisticated scanners, cloud-based storage solutions, and advanced algorithms has made digital pathology more accessible and efficient.
  • Labor Shortages and Cost Efficiency: Automation and digitization can help address labor shortages and reduce costs in the long term by streamlining workflows and improving efficiency.


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Barriers to Digital Pathology Adoption

While many drivers are pushing for continued adoption of digital pathology, some key barriers still remain:

  • High Initial Investment: The cost of acquiring scanners and storage solutions can be prohibitive for many institutions. Additionally, the return on investment will be long-term, rather than immediate, given the current state of reimbursement and cost saving capabilities.
  • Workflow Changes: Implementing digital pathology requires significant changes to existing workflows, which can be challenging for labs to manage.
  • Skepticism and Resistance: There is often resistance from pathologists who fear that algorithms may replace their roles. Overcoming this skepticism requires demonstrating the value of digital pathology as a tool to enhance, not replace, their expertise. 



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Beyond these drivers and barriers, key trends within the healthcare ecosystem are also creating significant tailwinds, further fueling the growth of digital pathology. Unlike in the past, where interest often fluctuated depending on the introduction of new products and capabilities, this momentum is now sustained and steadily growing.

Digital Pathology’s Strong Momentum

We believe the renewed interest and excitement around digital pathology will be sustained due to a few key trends:

  • Support from Pharma: Pharmaceutical companies are increasingly interested in digital pathology as a tool for developing new targeted therapies. The ability to identify specific patient cohorts and develop companion diagnostics is driving investment in this technology from some of the industry’s largest players.
  • Collaborative Ecosystem: Partnerships between scanner companies, algorithm developers, and healthcare institutions are creating a more integrated and interoperable ecosystem. This collaboration is making it easier for labs to adopt and implement digital pathology solutions.
  • Regulatory Support: Regulatory bodies are beginning to recognize the value of digital pathology, leading to more favorable guidelines and approvals. This support is crucial for widespread adoption.
  • Novel Oncology Drugs: There is a trend toward multivalent antibodies and other advanced modalities which are more likely to require multiplex immunohistochemistry and digital pathology companion diagnostic solutions.


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Conclusion 

While there are still barriers to overcome, digital pathology is experiencing sustained momentum, driven by stakeholders’ recognition of its significant benefits and favorable industry trends. As technological developments continue to unfold, it will be increasingly important to stay informed about novel technologies, and how to best integrate new capabilities.
To learn more about digital pathology and the industry dynamics influencing its growth, reach out to us or take a listen to our new podcast.
 

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