Addressing The Storage Crisis For Digital Pathology

There are multiple drivers for change in histopathology across the NHS and private sectors. Pathology services are facing huge pressures through rising workloads, the increasing complexity of their work, and staff vacancies of 10-12% and rising.

The volume of histopathology requests to laboratories has increased by around 4.5% on average year-on-year since 2007, with levels currently running at 1 billion tests a year. And it’s no wonder when approximately 95% of clinical pathways require access to pathology services.

NHS England recognised these issues and has been working with NHS Trusts across the country to institute pathology networks alongside its ‘digital first’ pathology strategy (with histopathology one of the seven key areas of focus); as it seeks to consolidate and improve services.

Histopathology Pitfalls – Don’t Fall Into The Traps

Digital transformation for pathology services is already underway and gathering momentum. But all too often the pathology networks or individual laboratories fall into the trap of simply procuring a scanner and laboratory information management system (LIMS) in the hope that the ‘digital transformation job’ is done! If only that were true.

Avoid ‘Vendor Lock-in’

There are real and present dangers for pathology services if they take the above approach. ‘Vendor lock-in’ is the first issue that springs to mind. When a pathology scanner photographs and generates images of the sample, they are generally ‘locked’ into the scanner’s tethered and proprietary archive. When we consider the need to make sample data across a pathology diagnostic network, if other organisations are using a different scanning and archiving solution, then there is little to no chance of them being able to access or view the original images. And if we take that up another level, if the scanning solutions cannot enable image interoperability, then electronic patient record (EPR) or shared cared record systems have no chance of full integration!

One potential solution might be to create a homogenous environment where a pathology network agrees to ‘swap out’ existing scanners in favour of a single vendor, ensuring interoperability. But that would constitute a huge, resource-intensive and time consuming project; and with the latest technology funding cuts, one that is almost certainly cost prohibitive.

Some scanner/technology providers purport to have ‘vendor neutral archives’ for digital pathology. But, as we learned from radiology, many claims to be truly ‘vendor neutral’ were marketing gimmicks employed to try and guarantee a PACS sale. So, my advice is to do your due diligence, ask the difficult questions around vendor neutrality and interoperability, and be careful who you trust!

Have A Strategy For Storing And Managing Your Pathology Data

The Royal College of Pathologists recommends retaining glass slides for at least 10 years¹. However, we now live in a digital world; and glass slides cannot easily be shared across pathology networks (unless physically transported). Nor can they be easily used for telepathology and/or outsourced reporting, multi-disciplinary team (MDT) meetings, or teaching in real-time. And these are many of the reasons why digital transformation in pathology is picking up pace.

For histopathology, scanners are now in place to digitise tissue samples from glass slides. Using digital images that can be shared, accessed, and viewed across regional pathology networks can certainly offset workforce shortages and increase productivity – both of which were highlighted in the Report of the Review of NHS Pathology Services in England chaired by Lord Carter of Coles.

However, though digitising pathology services brings many advantages, it also has its own challenges. Radiology is one of the most digitally mature departments and it’s still responsible for generating a huge percentage/proportion of a hospital’s data. If you think that between 2016/2017, the NHS conducted more than 42 million radiology examinations; consider the terabytes of imaging studies that resulted – all of which have to be stored, protected, and managed. When we think about pathology images, this is expected to dwarf radiology by comparison – we’re not talking terabytes, more petabytes or beyond. You might argue that culling your data is an option except that retention policy mandates prevent organisations from doing so.

When you then consider the volume of pathology samples scanned each year, the resulting data footprint, and then factor in data retention policies (let’s say 10 years), then storage becomes a major issue. On this basis, on-premise storage will become untenable for pathology; and Cloud storage costs will easily spiral out of control if not carefully monitored.

Another consideration to bear in mind is that pathology services tend to work across a number of laboratories and associated hospitals that make up the network. Each laboratory will be asked to undertake major data management activities due to the vast amount of pathology data being created locally. All of this information needs to be stored, protected, and managed; and the laboratories may not have the on-site IT personnel or skills to do this efficiently and cost-effectively.

Without a pathology data management strategy in place, your storage costs are set to ‘skyrocket’ year-on-year across the life of each image. But, don’t fear, this is where BridgeHead can help.

The BridgeHead Way For Pathology Data Management

With almost 30 years in healthcare data management, we have amassed knowledge and expertise in the best ways to optimise and manage all electronic information data specifically for healthcare. As a result, we are helping many NHS and private healthcare organisations to navigate their way through their digital transformation programmes and that includes pathology services.

We have developed a pathology solution, with our partners, that enables healthcare organisations to take advantage of a tiered storage architecture using the public Cloud. The solution is powered by data management software that implements policies to automatically move data to the best storage and media as best befits that information, as well as protecting it, for example, in the event of a cyberattack. And, because of our technology partnerships, we are able to provide access to all of the stored pathology data across your organisation or pathology network for viewing and reporting without crippling your network.

Why does this matter to you? Simply because you will be flabbergasted at the magnitude of cost savings as well as the significant efficiency gains BridgeHead is able to offer our customers in order to manage their pathology data across its lifecycle.


The aim of this blog was to highlight that there is a tsunami of pathology data heading your way (if you’re not victim to it already). Conventional approaches to managing that data are outdated, inefficient, and will leave you with a financial migraine that is difficult to remedy. ‘Doing nothing’ is not an option; and delaying the inevitable will just exacerbate the problem in the future. So, my advice to you to address the looming storage crisis for digital pathology is that you need a plan. If I can leave you with one thing, it’s to really consider your long-term data management strategy for your pathology data.

¹ Wilkins B. The retention and storage of pathological records and specimens (5th edition) London, UK: The Royal College of Pathologists, 2015

If you are interested in learning how BridgeHead can help you significantly reduce the total cost of ownership of your Digital Pathology data while laying the foundations for your long-term data management strategy…


Angela Single has worked in the Heath Technology field for over 20 years. A clinician by background she is passionate about the difference digital technology makes to patients and clinicians’ lives.  A Digital Transformation expert, Angela has worked globally to introduce new ways of working and delivering healthcare within the NHS. 

Angela joined BridgeHead in February 2020 and as Senior Director for EMEA, New Business and Partners EMEA has driven the Digital Pathology Initiative in conjunction with its partner Path Hub.