Pathoverse Part 2: Seeking Seamless Remote Consultations

Removing Friction from Digital Consult Workflows

This article summarizes part 2 of our “Into the Pathoverse” webinar, recorded at Pathology Visions 2025 in San Diego and available on-demand. This segment starts at 9:07 in the full video. Watch the full video.

Every major innovation begins with a spark—a problem so persistent and universal that someone finally decides to solve it. For PathPresenter, that spark came from a challenge faced by pathologists everywhere: managing digital pathology images at scale.

When the conversation turns to digital pathology, especially remote consultations, one theme consistently rises to the surface: friction. In this second segment of the Pathoverse webinar, Raj Singh laid out the many barriers that prevent hospitals from delivering fast, reliable digital consults—even when the expertise is readily available.

Pathologists are willing and prepared to provide second opinions. The issue, he emphasized, is not a shortage of talent. The issue is everything that happens before the expert ever sees the case.

ConsultConnect, a new solution from PathPresenter, was designed to eliminate that friction entirely, and via collaboration with Grundium and AWS, it’s enabling new progress.

Why Digital Consults Remain Surprisingly Slow

Although digital pathology has made tremendous strides, Raj pointed out that most consultation workflows are still stuck in the past. Even partner hospitals within the same health system often lack interoperable processes for exchanging consults, let alone independent hospitals seeking external second opinions.

The result is a slow, fragmented experience. Today, a consultation typically takes five to fourteen days before a final report is issued. Not because pathologists are unavailable—but because the logistics are cumbersome:

• Glass slides must be packaged, shipped, and accessioned.
• Additional stains may need to be ordered after the slide arrives.
• Referring institutions send paper folders filled with patient metadata that must be manually entered.
• Cases might involve multiple accession numbers and include gross images, radiology, clinical photos, and reports.

Even when hospitals attempt a digital approach, the process is rarely secure or efficient. Raj described scenarios familiar to many pathologists: digitized slides uploaded to Dropbox or Box (not HIPAA-compliant), sent without integrated viewers, and distributed in proprietary formats that receiving institutions cannot open. A Leica file may not open on a Philips viewer; a Hamamatsu file may not work with a Leica toolset. On top of that, the core logistical burden persists: images still need to be transferred, stored, and organized manually.

The Need for a New Type of Consultation Service

Raj argued that digital consultations require a fundamentally different service model—one that acknowledges the complexity of real consults. Pathologists often need not just slides, but clinical images, radiology, gross photos, reports, pathology notes, and ongoing communication with the referring provider.

Yet institutions struggle to build this infrastructure. High costs, storage requirements, lengthy implementation timelines, interoperability challenges, and the difficulty of securing funding from leadership all slow progress.

Hospitals want digital consults. Pathologists want digital consults. Patients certainly benefit from them. But the barrier has always been the same: implementing a complete and reliable system is hard.

Enter ConsultConnect

To address this gap, PathPresenter developed ConsultConnect, a turnkey solution that allows hospitals to start offering digital consults almost immediately, and without any upfront investment.

Raj described it as “the fastest and easiest route to digital pathology,” and also emphasized, following the recurring theme of the Pathoverse, that the route also depends on interoperability and collaborations with other innovators, in this case Grundium, providing cost-efficient slide scanners optimized for rapid deployment, and AWS, powering the secure cloud infrastructure needed for seamless data exchange.

Together with PathPresenter, these partners have created a streamlined consultation pipeline.

How ConsultConnect Works

The model is designed to eliminate every major barrier—from scanning to storage to data transfer. Raj explained the workflow in simple terms:

1. PathPresenter creates a customized web portal for the institution. This portal is provided at no cost and can be deployed within days.
2. Referring hospitals upload whole slide images, metadata, and supporting files directly into the portal. Scanners like Grundium’s new Ocus series are installed locally to minimize hardware expense.
3. PathPresenter’s HL7 middleware automatically transfers all information from the portal into the receiving institution’s LIS or digital dashboard.
4. Pathologists review the case within the PathPresenter IMS. They can request additional stains, communicate with the referring provider, and view all case materials in one place.
5. The completed report is uploaded back to the portal, where the referring hospital can immediately download it.

The process removes shipping delays, metadata errors, viewer incompatibilities, and the need for separate storage systems. Everything flows through a single, secure environment.

No Upfront Costs—and Deployment in Days

One of the most remarkable aspects of ConsultConnect is its financial model. Raj emphasized that institutions pay nothing up front to create the web portal or deploy storage. Costs begin only after consults start flowing, on a per-consult basis.

This makes approval from leadership significantly easier—and dramatically accelerates adoption. Instead of waiting months (or years) for capital projects and IT integrations, a hospital can begin offering digital consults in a matter of days.

Transforming the Economics of Digital Pathology

Raj noted that many pathology departments struggle to justify digital investments because they are often perceived as cost centers. ConsultConnect flips the narrative.

With digital consults in place:

• Institutions gain new revenue streams by offering remote second opinions.
• Departments can demonstrate profitability, strengthening the case for additional digital pathology investment.
• Pathologists can extend their reach globally, rather than being limited to local or regional consult requests.

For patients, the benefits are immediate—faster access to subspecialty expertise, improved diagnostic speed, and reduced risk associated with shipping fragile slides.

Setting the Stage for What Comes Next

Raj closed his segment by framing ConsultConnect as one part of a broader movement to unlock digital pathology’s potential. By eliminating the logistical pain points associated with consults, ConsultConnect frees institutions to focus on quality, collaboration, and clinical impact.

In Part 3, Todd Vanden Branden explores how Grundium scanners reinforce this mission by making digital pathology more accessible than ever.

Dive farther Into the Pathoverse:

Watch the complete video.

Part 1: Introducing the Pathoverse and How We Got Here – Dr. Raj Singh, PathPresenter

Part 2: Seeking Seamless Remote Consultations – Dr. Raj Singh, PathPresenter

Part 3: Lowering Barriers and Driving Consult Efficiency – Todd Vanden Branden, Grundium

Part 4: Cloud Infrastructure for Scalable Digital Pathology – Sasha Paegle, AWS

Part 5: Accelerating Clinical Trial Enrollment – Travis Wold, Imagenomix 

Part 6: Virtual Restaining for Scalable, High-Accuracy Pathology AI – Dr. Saad Nadeem, DeepLIIF/Memorial Sloan Kettering

Part 7: Conclusions: This is Just the Beginning – Dr. Raj Singh, PathPresenter

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