Digital Pathology for Consultation in the Military Health System: A Mixed Methods Evaluation of Pathologists' Impressions of Facilitators and Barriers to Implementation

Abstract

Challenging pathology case consultations require shipment of irretrievable patient materials to the consultants’ location for evaluation. In the military, consultants and generalists span geographically diverse locations. Shipped cases risk being lost, irreparably damaged in transit over extensive distances and diagnostic delays. Digital Pathology (DP) eliminates these risks.DP implementation efforts in the Military Health System have been unsuccessful, yet an investigation of tri-service pathologists’ attitudes towards this innovation has never been performed. Our explanatory mixed methods study used a web-based needs assessment and interviews to understand pathologists’ perceived facilitators and barriers to using DP for consultation. We believe that understanding their perceptions is critical if further implementation efforts are to be successful. Analyses showed that pathologists were receptive to enterprise-wide DP implementation, especially if it improved turnaround time and allowed immediate subspecialist feedback. Future DP implementation efforts may benefit from comprehensive technical support combined with a consolidated DP program office for implementation and sustainment guidance.