On the Road to Digital Pathology in Denmark: National Survey and Interviews

Digital pathology (DP) is changing pathology departments dramatically worldwide, yet globally, few departments are presently
digitalized for the full diagnostic workflow. Denmark is also on the road to full digitalization countrywide, and this study aim to
cover experiences during the implementation process in a national context. Thus, quantitative questionnaires were distributed
to all pathology departments in Denmark (n = 13) and distributed to all professions including medical clinical directors, medical
doctors (MD) and biomedical laboratory scientists (BLS). For a qualitative perspective, we interviewed four employees
representing four professions. Data were collected in 2019–2020. From the questionnaire and interviews, we found strategies
differed at the Danish departments with regards to ambitions, technological equipment, workflows, and involvement of type
of professions. DP education was requested by personnel. Informants were in general positive toward the digital future but
mainly had concerns regarding the political pressure to integrate DP before technological advances are sufficient for maintaining
rational budgets, workflows, and for sustaining diagnostic quality. This study is a glance on the Danish implementation
process in its early stages from personnel’s point of view. It shows the complexity when large new workflow processes are
to be implemented countrywide and with a large diversity of stakeholders like managers, MD, BLS, IT-professionals, and
authorities. To ensure best technological and economical solutions and to maintain—or even optimize—diagnostic quality
with DP and workflow alignment, we suggest superior inter- and intradepartmental communication. When implementing DP
countrywide, a national working group is warranted with the variety of stakeholders represented.