Abstract
BACKGROUND/OBJECTIVE: Digital pathology (DP) encompasses the digitization of processes related to the acquisition, storage, transmission, and analysis of pathological data, contrasting with conventional methodology (CM) using optical microscopes. This study evaluates the efficiency of DP versus CM in a Spanish pathology department. METHODS: Observational, retrospective, and non-interventional study comparing biopsy samples from 2021 (cases diagnosed using CM) and 2022 (using DP). Variables analyzed were the pathologist who made the diagnosis, the number of slides, and the case area. Outcome efficiency variables were the turnaround-time (TaT), pending cases (active cases each pathologist accumulates daily), and pathologist workload. A significance level of 5% was established, and an exploratory cost-analysis was also performed. RESULTS: 11,922 cases were analyzed: 5,836 and 6,086 diagnosed with CM and DP methodologies, respectively. Mean TaT for CM-diagnosed cases was 10.58 (standard deviation [SD] 7.10) days, compared to 6.86 (SD 5.10) days for DP-diagnosed cases, reflecting a reduction of 3.72 days (P < 0.001). With DP, the average reduction in pending cases over a year was around 25 cases, with peaks of 100 fewer pending cases during high workload months. Additionally, DP decreased the pathologist workload by 29.2% on average, with reductions exceeding 50% during peak months. CONCLUSION: Our study is the first in Spain to compare the efficiency and costs of DP and CM. DP demonstrated significant efficiency improvements over CM, reducing TaT and pathologist workload. Despite higher initial costs, DP's operational benefits indicate its potential as a transformative diagnostic tool. Further studies are needed to evaluate its long-term cost-effectiveness.