The Board has been announcing it since last summer. The Pathological Anatomy services of the 14 hospitals of the autonomous community are going to be protagonists of a paradigm shift in the way they work like no other in recent decades: digital pathology is arriving, which is going to replace microscopes with scanners and will incorporate an entire image management system with algorithms to help diagnoses that will allow these to be, in the words of the pathologist from the University Hospital of Burgos (HUBU) Johanna Palacios, “faster, with less subjectivity and with greater efficiency”.
Palacios, who is part, along with the head of the service, Enrique García Toro, of the Digital Pathology Group of Castilla y León, has been one of those in charge of analyzing the digitalization that hospitals in other parts of Spain have carried out and submitting it to stress test on all the equipment offered on the market. This field work and that which has been done with the general directorates of Digital Health and Infrastructure of the Ministry of Health, “in a magnificent collaboration”, in his words, is what made it possible to announce an investment of more than 6 million euros. Part of which will be contributed by the Measures Development Program to improve the Efficiency and Sustainability of the National Health System in the field of digital health, included within the Recovery, Transformation and Resilience Plan of the central Government and the European Union. Thus, two scanners, 21 workstations for clinical diagnosis, an 85-inch screen and 3 55-inch screens will arrive at the HUBU before October next year – those are, at least, the forecasts.
This is a process that will continue the path begun some time ago towards personalized or precision medicine in which the treatment is tailored to the needs, characteristics, lifestyle, and genetics of each patient. “In short, digital pathology will offer an improvement in care that, in addition, provides great equity since with networking – since we will be able to connect between hospitals in the community and outside it – the care will be the same for “for a person who lives in the town further away from a regional hospital than for someone who lives in the city,” adds Johanna Palacios.
Although Pathological Anatomy is one of the central services of the HUBU – which means that it works for the rest of the areas, both medical and surgical – it is probably one of the most unknown. Few people know that in the time that passes between the performance of many of the diagnostic tests that are done in the hospital and their results, it is these professionals (a team of 32 people) who are responsible for confirming whether, for example, a tumor is benign or malignant and to indicate what type of treatment is needed. This medical specialty is responsible for studying and analyzing the cellular structure to explain the reasons for different diseases from the morphological to the molecular. To do this, it analyzes tissues or organs that can range from a small sample of skin sent by Dermatology, for example, to a surgical piece of an organ affected by a tumor that is removed during a surgical procedure.
Its fundamental tool until now has been the microscope, an “optical and mechanical” mechanism, as Enrique García Toro describes it and in whose use all the knowledge of the specialists and their experience is involved, hence the talk of subjectivity in this process. diagnosis. “In the laboratory, the samples are processed until a histological preparation is obtained, a glass in which a very fine cut of the sample is placed with dye, which is what we have always looked at with the microscope, which is why the technological leap is to now be of great magnitude,” comments the expert, who describes the new developments and advances that digital pathology will bring as a “revolution.”
The image management system that the equipment will include will allow us to see with hitherto unprecedented precision all the parts of the cells of the tissue or organ being analyzed. In addition, it will be possible to store the samples in optimal condition (now, over time they deteriorate), which will also be very helpful for research, epidemiological studies and to incorporate in patients all the advances that are produced and that are beneficial for your pathology. On the other hand, links will be generated that can be sent by any type of messaging (email, WhatsApp…) to pathologists from other hospitals if a second opinion is required and carry out what Johanna Palacios calls “dynamic consultations” in real time. with colleagues from other parts of the country: “It will also be very useful for the committees that exist in the hospital with other specialties and even for teleworking.”
The images that the scanners will offer will be very detailed and the workflows will be completely automated: «From the first moment, from the moment the patient’s sample comes out until the crystal reaches us, everything is diagnosed and a biopsy is closed. It will be automated and will help reduce errors that may occur at any point in the process,” adds García Toro.
And how will the tortuous connectivity that the HUBU has had since its opening be saved? This lack of internet in many areas of the hospital, which causes the voice mailboxes of mobile phones to go off and the network of networks to be even intuited, has already been contemplated and planned by bidding and awarding the expansion of infrastructure and storage so that Get faster downloading of images.
Of the six professionals that make up the Castilla y León Digital Pathology Group, which this week received the first prize in the Castilla y León Health Innovation Challenges Contest for Personalized and Precision Medicine, two are García Toro and Palacios, from HUBU. The rest are Belén Tristán, from Ávila, who has worked in tandem with Palacios in the field work; Rocío Martín, also from Ávila; José Santos, from León, and Ma Ángeles Torres, from the Río Hortega Hospital in Valladolid, the center that has hosted the pilot project.