title: Using computerized workflow simulations to assess the feasibility of whole slide imaging full adoption in a high-volume histology laboratory.
abstract: BACKGROUND
  Whole slide Imaging (WSI) has been touted by many as the future of pathology, with estimates of full adoption occurring sometime in the next 5 to 15 years. While WSI devices have become increasingly capable since their inception, there has been little consideration of how WSI will be implemented and subsequently affect the workflow of high volume histology laboratories.
  
  
  METHODS
  Histology workflow process data was collected from a high-volume histology laboratory (Massachusetts General Hospital) and a process model developed using business process management software. Computerized workflow simulations were performed and total histology process time evaluated under a number of different WSI conditions.
  
  
  RESULTS
  Total histology process time increased approximately 10-fold to 20-fold over baseline with the presence of one WSI robot in the histology workflow. Depending on the specifications of the WSI robot, anywhere from 9 to 14 WSI robots were required within the histology workflow to minimize the effects of WSI.
  
  
  CONCLUSIONS
  Placing a WSI robot into the current workflow of a high-volume histology laboratory with the intent of full adoption is not feasible. Implementing WSI without making significant changes to the current workflow of the histology laboratory would prove to be both disruptive and costly to surgical pathology.
authors: Department of Pathology, Massachusetts General Hospital, Boston, USA. dsmcclin@gmail.com
authors: David S
authors: DS
authors: McClintock
authors: Roy E
authors: RE
authors: Lee
authors: John R
authors: JR
authors: Gilbertson
mesh_terms: D003198:Computer Simulation; D005240:Feasibility Studies; D006652:Histological Techniques / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008962:Models, Theoretical; D010338:Pathology, Clinical / Q000379:methods*; D015203:Reproducibility of Results; D013997:Time Factors