Pathology is shifting from microscopes to screens and data. In Slovakia, since 2023 it has been accelerated by the Digitalizovaná patológia project supported by artificial intelligence under the auspices of the Ministry of Health, funded by the Recovery and Resilience Plan. It delivers a faster process, fewer errors, and new opportunities for collaboration, but also demands on technology and people.
What a digital pathology department looks like
Digitization is not just slide scanning, but a fully digital workflow. From the moment the sample arrives, it is accompanied by an electronic request form, and the entire process is managed by a laboratory information system. Paraffin blocks and slides are labeled with digital codes; after staining they are scanned by high-performance scanners, producing a digital image. The results are structured and ready to be linked with healthcare providers' information systems.
The digital image opens up new tools for the physician's work. It enables precise measurements, consistent annotations, and at the same time synchronized comparison of multiple slides, which a conventional microscope does not offer. A digital archive speeds up retrieval of older cases and their comparison with new ones. In Slovakia, 18 sites have joined the transformation within the project, but other laboratories outside it are also digitizing.
Artificial intelligence and telepathology in practice
Artificial intelligence increases both efficiency and quality. In the background it can assign cases according to physicians' workload and specialization, while also checking scan quality so that errors are caught right at the beginning. In the diagnosis itself it helps mainly with quantitative tasks, such as counting positive cells in immunohistochemical examinations or assessing the number of mitoses. The result is faster and more consistent interpretation of findings.
Telepathology expands access to expertise and operational flexibility. It enables remote consultations between sites and working from home where the nature of the case allows it. An important benefit is also support for intraoperative examinations remotely in regions without a pathologist on site. This shortens decision times and reduces logistical barriers.
Pitfalls, standards, and what's next
The biggest obstacle is the high upfront cost of hardware, software, and especially data storage, as well as their long-term sustainability. Strong IT support for infrastructure and cybersecurity is crucial; otherwise the process easily stalls. Laboratories must adjust workflows and physicians must adapt from microscope to screen, which temporarily reduces throughput. New AI-based diagnostic procedures are also emerging, which should be clearly defined and reimbursed by insurers.
Europe does not yet have uniform binding rules; an ISO standard is being prepared and professional recommendations exist. For easy collaboration, a unified format of digital images is important, similar to radiology. The vision for the future counts on AI as a “copilot,” massive use in education, and digital biomarkers that can speed up the selection of targeted therapy compared with time-consuming genetics. Digital pathology is thus heading towards more precise, faster, and more accessible diagnostics.
