Digital Pathology Basics: What is Digital Pathology

From Glass Slides to Intelligent Diagnostics

Pathology sits quietly at the center of modern medicine. Although patients may never meet a pathologist, roughly 70% of clinical decisions are influenced by pathology reports, earning pathologists the nickname “the doctor’s doctor.” For more than a century, however, the core pathology workflow has remained largely unchanged: tissue is mounted on a glass slide, examined under a microscope, diagnosed by a specialist, and then physically stored for future reference.

Digital pathology represents a fundamental shift beyond this analog process toward a data-driven, connected, and computational future.

What Is Digital Pathology?

Digital pathology refers to the acquisition, management, sharing, and analysis of pathology information in a digital environment. At its core, this involves converting traditional glass slides into high-resolution digital images using specialized scanners, a process known as whole slide imaging (WSI). Once digitized, these images can be viewed, shared, analyzed, and archived electronically rather than handled and stored physically.

But digital pathology is more than simply scanning slides. Digital pathology and informatics combine imaging, laboratory data, information systems, and advanced analytics including artificial intelligence (AI) to support diagnosis, research, and patient care.

The Traditional Pathology Workflow…and Its Limits

The conventional workflow has been largely unchanged for over 100 years: a tissue sample is prepared on a glass slide, reviewed by a pathologist under a microscope, diagnosed, and then placed into long-term storage. The final pathology report becomes part of the patient’s medical records, which are increasingly migrating to electronic health record (EHR) systems.

While this process has delivered reliable diagnoses for decades, it comes with limitations:

Physical slides must be manually transported, stored, and retrieved
Sharing cases for consultation or second opinions is slow and logistically complex
Access is limited to the location of the microscope and slides
Slide information remains firmly analog. Without images, slide information is inaccessible to computational analysis

These constraints have become more apparent as healthcare systems seek faster workflows, remote collaboration, and data-driven insights.

The Digital Pathology Workflow

A digital pathology workflow begins with slides like the traditional process, but quickly adds key digital enhancements:

Tissue Preparation – Samples are still prepared on glass slides using standard histology techniques.
Slide Scanning – Slides are scanned using high-resolution scanners, producing extremely large image files. Scanner capabilities vary widely in throughput, resolution, and file format, creating opportunities (and challenges) for standardization and quality control.
Image Upload and Management – Digital slides are stored and organized within image management systems (IMS), which must handle massive data volumes and integrate with laboratory information systems (LIS), picture archiving systems (PACS), and EHRs
Diagnosis – Pathologists review images through digital viewers, usually part of an IMS and ideally directly integrated with the organization’s LIS. The digital format enables remote access, rapid consultation, and the use of AI-based decision support tools.
Reporting – Diagnostic reports flow back into the LIS and onward to treating clinicians, with opportunities for automation of routine administrative tasks

This end-to-end digital flow reduces friction, increases accessibility, and creates a foundation for computational analysis.

The Benefits of Digital Pathology

The benefits of digital pathology extend beyond convenience. Key advantages include:

Operational efficiency – Digital slides eliminate much of the manual handling, transport, and physical storage required for glass slides.
Speed and accessibility – Digital data moves faster than physical specimens, enabling quicker diagnoses and easier sharing across locations.
Remote work and collaboration – Pathologists can review cases from anywhere, supporting telepathology, virtual tumor boards, and global second opinions.
Automation and integration – Digital workflows can connect pathology data with other clinical systems, reducing administrative burden and errors.
Advanced analytics – Digitized images unlock AI-driven image analysis, supporting tasks such as quantification, pattern recognition, and quality control

Together, these capabilities help address growing diagnostic workloads and workforce shortages while improving consistency and scalability.

Digital Pathology as Big Data

Once pathology becomes digital, it becomes data, and a lot of it. Whole slide images are each often multiple gigabytes in size and are among the largest data objects in healthcare. Indeed, file storage can become a significant issue and one of the largest cost drivers in digital pathology. When combined with other data types, WSIs form part of a rapidly expanding biomedical data ecosystem.

Done properly, digital pathology data can be integrated with:

Genomics and molecular data
Radiology images (radiomics)
Clinical history and treatment outcomes
Institutional and population-level datasets

This convergence enables new fields such as pathomics, where computational analysis extracts quantitative features from pathology images at a scale impossible for human observers alone.

These datasets power research, clinical trials, drug discovery, and AI model development across academia, healthcare systems, and the life sciences industry.

The Hidden Complexity of Going Digital

Despite its promise, digital pathology is not a simple “plug-and-play” transformation. Purchasing scanners and viewing software is only the visible tip of the iceberg. Successful implementation requires alignment across technology, people, and processes.

Key challenges include:

Managing massive image storage and data transfer
Integrating multiple systems and vendors
Ensuring regulatory compliance and validation
Training pathologists and laboratory staff
Adapting workflows that have been stable for decades

Hidden complexities often emerge mid-implementation, making domain expertise and flexible system design essential, and highlighting the need for organizations to carefully choose a workflow partner with deep domain knowledge, flexibility and expertise.

Pathology: at the Center of Personalized Medicine

At its full potential, digital pathology becomes a central hub for personalized medicine. By connecting diagnostic images with molecular profiles, clinical history, and treatment response, healthcare systems can move toward more precise diagnoses, better risk stratification, and tailored therapies.

Digitization breaks down data silos and creates new opportunities across clinical care, research, and education, positioning pathology not just as a diagnostic service, but as a foundational data science discipline in modern healthcare.

More Information

Are you or your organization considering a digital pathology project? We’d love to discuss your unique needs and help you explore the best solution.