Interview with Scott Kilcoyne
In this interview, Scott Kilcoyne, Chief Operating Officer and Co-Founder of DigitCells, discusses the recent innovations at DigitCells trends and challenges in digital pathology, and his visions for the future of digital pathology.
Can you describe some of the most recent innovations in digital pathology that DigitCells has been working on?
DigitCells has been working on several innovative products, including our Tissue Workflow Optimization for Digital (TWOD) system, which enhances histologic and point-of-biopsy uniformity and security. This represents a significant step forward in how prostate biopsies are identified and transferred to the lab.
Additionally, we have some exciting research projects underway that will ultimately add value to our platform by providing improved information about the biopsy, such as automated scoring, categorization, tumor grading, and histologic quality. We’re also rolling this model out to the GoPath network of urology laboratories and clinicians, allowing us to gather real-time data on efficiencies, deficiencies, and the biopsy and reporting process.
How do these innovations improve diagnostic accuracy and workflow efficiency in pathology labs?
Compared to analog methods, our tissue optimization system significantly improves various efficiencies, including processing time, scanning time, and pathologist review time.
Additionally, by reducing the number of cassettes and slides used, we can achieve substantial cost savings, which in turn lowers the costs associated with traditional biopsy sampling and processing methods.
What are some of the key technological advancements in digital pathology that you believe are shaping the future of the field?
Current technology in digital pathology keeps improving, which is encouraging. Over the past 15 years, scanning a slide has evolved from a slow and cumbersome process to something that is now fast and efficient, with continuous enhancements. While improving existing capabilities is crucial, new technologies are also emerging that further speed up scanning and reduce the large file sizes typically associated with scanned images.
Furthermore, features like serial scanning are advancing the field. Traditionally, a rack of slides would be loaded, and each slide scanned one by one. With serial scanning, multiple slides can be scanned simultaneously on separate platforms significantly enhancing the reputation and efficiency of digital pathology.
What are the main challenges you’ve faced in developing and implementing new technologies in digital pathology?
The main challenge we face is that the vast majority of pathologists prioritize seeing reimbursement. This is the number one hurdle in the field, as the costs involved in adopting new technologies are significant, and the return on investment or innovation isn’t immediately apparent. If you present a proforma model showing cost savings over a year or two, the adoption can vary greatly depending on the pathologists’ openness to digital pathology. In groups with resistance, the implementation process can be much longer and slower.
Another challenge is geographical. The areas most in need of digital pathology, such as remote or resource-limited locations, present unique difficulties. For example, think of a Navy hospital on a ship-it’s challenging to station pathologists on a ship for extended periods. They’ve addressed this by placing a few rotating histotechs on board and installing a scanner. This scenario mirrors the situation in hospitals located in remote areas, whether in Eastern Europe, Africa, or even rural America, where providing adequate support can be a significant challenge.
How has customer feedback influenced the development of your digital pathology solutions?
Customer feedback is the number one influencer in our development process. We might develop a system that we believe works well internally, but once it’s deployed at a pilot site or with a customer, we receive valuable insights. This feedback has led to improvements in areas such as image quality and macro image quality.
Sometimes, the pathologist may try a platform and find that it doesn’t meet their needs – such as preferring a slide box over a slide tray. In these cases, we need to adjust and provide a different model. Overall, customer feedback plays a crucial role in shaping our digital pathology solutions.
What future trends do you foresee in digital pathology, and how is DigitCells preparing to adapt to or lead these trends?
The biggest users of digital pathology are community pathologists, so we anticipate that the trend will shift in that direction. Currently, there’s an overfocus on academic institutions, which makes sense since they were the first adopters. Institutions like UCSF, OSU, and Mayo Clinic – now 100% digital – were pioneers in this space. However, as we’ve proven the effectiveness of digital pathology in these settings, the trend is likely to move away from academics and toward community hospitals.
To prepare for this shift, DigitCells is focused on providing a complete end-to-end solution for community hospitals. Given the many demands on laboratories today, our goal is to be the company that can install a fully functional digital system within one or two days, seamlessly integrating with their laboratory information system. We aim to make adoption as easy and pain-free as possible, recognizing that simplicity and accessibility are key for community pathologists.
How do you see digital pathology integrating with other emerging technologies, such as artificial intelligence or genomics?
Well, those are two huge questions. When it comes to integrating digital pathology with artificial intelligence, the two are set to go hand in hand across multiple fronts. Imagine pathologists sitting down at a computer and simply saying, ‘Show me all my biopsies for today, starting with the benign prostate cases.’ Immediately, those cases would be presented on the pathologist’s screen for review. The AI could prioritize cases, whether benign or more complex, allowing pathologists to focus on what they choose first. This is just one aspect, of leveraging natural language processing.
Beyond that, AI can do so much more – triaging cases, identifying tissue types, and adding metadata to images in real-time. You could place a slide on a scanner, and the AI would classify the tissue and highlight areas of interest, speeding up scan times and improving communication and data efficiency. Diagnostic AI could also determine the type of cancer, and the percentage of cancerous cells in a biopsy, and even handle cell counting, quantifying all that data. There’s a lot more I could mention, but the integration of AI and digital pathology will be extensive and transformative.
As for genomics, it’s especially intriguing here at GoPath, where we have both molecular and digital components. The key connection between the two lies in being able to image a biopsy and identify the area with the highest percentage of specific staining for a variant or malignancy. We can then target that precise area for genomic testing, offering a more accurate alignment between anatomic pathology and genomic testing. This integration will significantly enhance the precision and effectiveness of laboratory diagnostics.
Can you share any real-world examples or case studies where DigitCells’ innovations have made a significant impact?
A real-world example would be a pathology research center in Georgia, Eastern Europe. Their pathologist came to the U.S. seeking a partnership with a laboratory that could provide immunostaining, molecular services, and FISH for their patients.
This partnership represents a unique hybrid model. We installed a scanner at their facility, enabling them to perform digital consultations. They scan the slides and send them to us. If our GoPath pathologists determine that a specific immunostain is needed, the research center cuts an unstained slide and ships it to us from Georgia using a courier service. We then stain the slide, digitize it, and our pathologists complete the read on the IHC. This collaboration allows us to overcome geographic challenges and deliver better patient care.
What is your vision for the future pathology, and how does DigitCells plan to continue driving innovation in this space?
Well, the future of pathology holds incredible potential, limited only by our imagination. One exciting advancement on the horizon is virtual staining, a technology that could eliminate the need for traditional chemicals or reagents. Instead, optics and imaging systems could assign virtual biomarkers and staining to tissue samples without the need for sectioning. Additionally, we could eventually run genetic tests on tumors and even discover the tumor microbiome using a single imaging system. While this may be 100 years into the future, it’s exciting to think about where pathology is headed.
In the immediate future, I envision a fully digitized system where every lab worldwide is supported by a digital platform. This would be the foundation. From there, we could see advanced robotics, with automated systems that move through labs, find slides, and digitize them. Another key aspect is global connectivity, enabling us to support every hospital and lab, regardless of location. Currently, there’s a misalignment between where pathologists are and where populations reside, leading to underserved communities. As diagnostics become more widely available, patients will demand more answers, and those answers will come from pathology – from the lab. It’s well known in our industry that 60 to 80% of all medical decisions are based on lab results.
This transcript has been edited for clarity.
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