How to support current pathology workflows while building a scalable path for modernization
The field of pathology constantly undergoes meaningful changes, but not all of them are making the latest headlines. While AI and fully digital workflows are busy turning heads, today’s labs still face persistent and high-impact challenges.
Two of the most common and most time-sensitive revolve around Intraoperative Consultations (IC) and Rapid Onsite Evaluation (ROSE). Pathology teams across the U.S. perform these every day, often multiple times a day in hospitals of all sizes.
During an IC, a real-time service requested by a surgeon during cancer surgery, the pathologist is typically asked to perform a Frozen Section. This is a very common technique, and its use continues to increase, where tissue is rapidly frozen, cut into extremely thin slices, stained and reviewed on the spot for an immediate margin assessment or tissue characterization. This can include breast, head and neck, gastrointestinal, orthopedic, neuro or gynecologic cases.
ROSE is an equally important and standard practice used to ensure there is sufficient cellular content for a diagnostic examination and is strongly recommended to reduce repeated biopsies. It’s typically performed during Fine-Needle Aspirations (FNA) of lung nodes, thyroid nodules, lymph nodes, pancreas, liver and other deep tissue.
While both methods offer critical patient information, their value lies in the fact that they deliver answers instantaneously. But what if they begin to lose that value?
The Clinical Pressure Points of Intraoperative Consultations and ROSE
When the speed of ICs and ROSE are compromised, the consequences ripple to longer anesthesia times, disrupted operating room (OR) schedules, repeat biopsies and overall, longer wait times for patients to get answers. That’s in addition to the risk of operational pressures such as staffing shortages, high surgical volumes and expectations for faster turnaround times.
ICs give surgeons immediate guidance; whether it’s assessing margins, identifying unexpected findings or confirming tissue states, the procedure directly influences surgical decisions while the patient is still on the table. While there are no strict formal guideline, the College of American Pathologists, who are responsible for all laboratory certifications and inspections, suggests that 90% of all Frozen Section procedures, with only one specimen, should be completed within 20 minutes. For more complex cases, turnaround time can extend to 40 minutes, as they may require multiple samples. Any additional delays can extend OR time, increase surgery complications and disrupt both the surgeon’s and patient’s schedule.
While ICs are very valuable, they also introduce quality challenges. Although Frozen Sections were originally developed at Johns Hopkins in the 1800s and embedded by the Mayo Clinic into regular surgical procedures by the 1900s, pathologists still find the technique challenging to learn and practice. Unless labs have the right equipment to control freeze rates, the rapid freezing process can distort the shape of tissue, particularly tissue with a lot of body fat, creating artifacts that alter the size and appearance of cells. These changes make it difficult for pathologists to interpret the slice under significant time pressure, making image clarity and resolution especially important during ICs.
ROSE holds a similar role during FNAs. Adequacy assessments ensure that the collected tissue sample contains cells of diagnostic value before the patient leaves the facility. Without this service, patients face the possibility of having to go back for another biopsy or false negative test results. That said, the rate of performed FNAs is declining in favor of a Core Needle Biopsies (CNBs) which provide larger and more intact tissue sample due to its histological approach rather than a cytological one.
Both methods require instant access to the slide, and there is little room for mistakes or delays.
Why Real-Time Telemicroscopy Fits These Needs
Live Robotic Microscopy (LRM) directly addresses the pressure points of ICs and ROSE by enabling a remote pathologist to examine the glass slide in real time. With full control of focus, magnification and navigation, the pathologist can evaluate the specimen as if they were using a physical microscope. Mikroscan is also one of the few vendors that offer 4K image resolution, helping pathologists to identify ambiguous image artifacts, further supporting more confident assessments during time-sensitive situations.
This approach supports distributed staffing models, reduces OR downtime and fills the gap when a pathologist is not physically present or available. For labs navigating staffing shortages or unpredictable caseloads, real-time telemicroscopy has become a reliable way to maintain quality and responsiveness.
Expanding Capabilities with a Dual Mode Approach
While real-time microscopy is essential for ICs and ROSE, many pathology teams also need tools that support education and collaboration with other labs. This is where Mikroscan’s digital scanner, the SL5, comes into play. Its design gives labs a flexible platform to support a wider range of modern pathology needs.
Telemicroscopy with our L5 tool remains a clinical anchor for time-sensitive procedures, but the SL5’s Scan Mode introduces additional capabilities that help teams build confidence with their digital readings. The SL5 supports research, education and training, making it ideal for pathologists in those areas.
Working Toward Modernization
For many labs, modernization is not a single jump. It takes time. A gradual approach helps teams adopt new tools without disrupting clinical workflows.
By pairing real-time telemicroscopy with high-quality digital scanning for research purposes, labs receive a practical path toward future AI adoption while still supporting current initiatives in clinical settings.
Mikroscan’s dual-mode systems support each phase, helping labs modernize at a pace that aligns with their needs, resources and regulatory requirements.
Preparing for 2026 and Beyond
The future of pathology will inevitably include more digital tools, remote collaboration and AI. But to get there, it begins with the foundations and workflows of today.
Real-time telemicroscopy continues to strengthen immediate evaluation, quick decision-making and reliable access to remote expertise. Digital scanning, on the other hand, is setting up the foundation for the long run. As the pathology field continues to evolve, Mikroscan is committed to continue partnering with labs to enhance the quality and consistency of patient care.
If you’re interested in scheduling a demo or learning how Mikroscan can help you, contact us today.
