Alexy Polivany

# The Cost-Per-Case Math That Keeps Small and Mid-Size Labs Out of Digital Pathology Ask why a 20,000-case-a-year community lab hasn't gone digital and you will usually be told a story about confidence: pathologists don't trust the screen, the validation burden is scary, the technology isn't ready. That story is now mostly wrong. Whole slide imaging systems have been cleared for primary diagnosis in the US since 2017, validation methodology is published and stable, and most pathologists under...

A surgical pathology specimen travels through more hands than most people realise. It arrives from the operating room or clinic, gets accessioned, assigned a case number, logged, transported to the gross room, dissected, placed into cassettes, processed overnight, embedded in paraffin, sectioned, stained, mounted, and finally presented to a pathologist for diagnosis. At each one of those steps, a human being handles something that must remain correctly identified and correctly attributed to...

Every cytology case that gets signed out as negative carries an implicit claim: a trained professional reviewed this material, found nothing actionable, and the patient can be managed accordingly. That claim rests entirely on human attention — and human attention is variable. It varies by screener experience, by time of day, by workload, by the monotony of reviewing slide after slide of normal material. The literature on screening fatigue in cytology is substantial. The consequence when...