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With support from Royal Philips, Oxford University Hospitals (OUH) NHS Foundation Trust has become one of the earliest UK adopters of a fully digitised cellular pathology (histopathology) department. OUH is one of the first NHS trusts in the country to achieve the milestone of digitising all surgical histology and referral slides within the cellular pathology department. This step-change is expected to unlock greater collaboration between OUH and its wider network of trusts and pathologists, resulting in more streamlined diagnosis for patients.

OUH has installed the Philips IntelliSite Pathology Solution, including three Ultra-Fast Scanners and one Ultra Versatile Scanner. This technology will reduce the pressure on the hospital’s cellular pathology service, supporting the vision of digitally enabled care as outlined in the NHS Long Term Plan. The transition to digital pathology has been driven by the pathology and biomedical science teams working closely together to deliver on a joined-up ambition to fully transition to digitisation. Introducing these solutions makes OUH better placed to lead the way in setting standards in multi-trust collaboration with regional partners. Its alliance with Milton Keynes University Hospital and Great Western Hospital in Swindon, which are also using the Philips IntelliSite Pathology Solutions, has allowed for multi-disciplinary team meeting cases to be reviewed digitally and for extra tests to be requested if necessary, expediting results and diagnostic decision-making.

Professor Clare Verrill, Associate Professor and Honorary Consultant in histopathology at OUH, commented: “We have seen a number of urgent cases where we have been able to provide a rapid opinion through digital solutions. In one case the digital platform enabled us to secure a crucial second opinion in a matter of hours, enabling the patient to start on life-saving chemotherapy treatment that evening. “Although it is still early days, we have seen that the Philips IntelliSite platform has great potential to improve diagnosis quality through increased access to further opinions and to help us deliver faster results to patients.”

In a recently published article in the Journal of Clinical Pathology, OUH Histopathology Consultant Dr Lisa Browning noted that, as a result of the COVID-19 pandemic, there had been a 25% increase in uptake of digital pathology, with pathologists keen to fully validate digitally and provide remote training and ongoing support for this transition successfully via videoconferencing.  By fully embracing digitisation, OUH has been able to continue with its medical education programmes, without any negative impact to quality of diagnosis. Through the first wave of the pandemic, the OUH team have not always been able to physically gather as a team but the Philips IntelliSite platform has enabled continued teaching and training of junior histopathologists under remote conditions.  Roles for biomedical science staff have also been able to be extended; for example, providing training and slide-viewing sessions for staff taking part in specimen dissection, a role previously undertaken by pathologists.

Prof Verrill is leading the Oxford team for the PathLAKE Centre of Excellence in Digital Pathology and AI of which Philips is the principal industrial partner. Her successful programme on digital pathology and artificial intelligence has been supported by the NIHR Oxford Biomedical Research Centre. The PathLAKE project will create a secure data-lake of tens of thousands of professionally annotated anonymous images for building deep learning algorithms that can automatically detect cancer. These images and tools will be made available across the consortium including a growing number of SME partners in this sector to develop artificial intelligence (AI) to overcome burgeoning workloads in the UK and establish a world-leading UK digital health industry.

OUH is a world-renowned centre of clinical excellence and one of the largest NHS teaching trusts in the UK. It provides a wide range of clinical, specialist services including cardiac, cancer, musculoskeletal and neurological rehabilitation, medical education, training and research.  The cellular pathology department processes around 60,000 cases per year, resulting in approximately 300,000 slides.

Over the years, OUH has invested significantly in the training of its 30 consultant pathologists and highly qualified teams in providing care to the members of its community. Many pathologists in the department have now completed their digital validation so cases can be reported digitally with the remainder of pathologists to follow in the near future. The team continue to work on refining processes, for example creating a ‘one-stop’ reporting portal with macroscopic images of specimens and scanned request forms.

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