Up to a few years ago, the management of the information on the slides (virtual slides) in telepathology applications was principally based on the design and construction of a few identical and expensive platforms with microscope units and software tools for the display and for electronic control (zooming, moving, and cutting of images). The development of information technology tools allows the diffusion of new visualization strategies and the availability of low cost or free visualization proprietary tools. New competitive systems such as client-server architectures are available in telepathology today. The investigation of the new technologies for telepathology is a basic and core aspect in telemedicine technology assessment. A new interactive environment to investigate the health technology assessment of a telepathology system has been studied. In particular, in consideration of previous experience the methodology focused both on the senior pathologist and younger student pathologist. Two interactive forms were created by a working group: a feedback form and a diagnostic form. The first was designed to investigate the technology characteristics and acceptance of the telepathology systems. The second tool was designed to investigate the diagnostic accuracy on a significant sample of virtual slides by two different groups of pathologists (senior and younger students). The acceptance of the methodology was very high.

The Italian Laurea for Health Care Professionals furnishes a high level of learning to technical personnel who will be involved in the healthcare system. It also represents a test for new models of learning in e-health and telemedicine applications. The purpose of this work was to investigate the changes in the biomedical laboratory curriculum in the healthcare system as a result of the introduction of telepathology (TP). Changes were categorized in two stages. The first stage was the inclusion of the TP as a support methodology using external furnishers to digitize the glass slides. The second is the inclusion of the TP as a consolidated routine methodology using a dedicated internal scanner to digitize the glass slides. New modules of learning have been designed to run on the wide area network to allow a better familiarization with new technologies. These new methodologies have been tested and present three tangible advantages: (1) A high level of knowledge for the student; (2) A cost-benefit advantage to the student; and (3) A cost-benefit advantage to the hospital. As the biomedical laboratories are freed up from academic applications, they thus become more available for clinical use.

We have investigated the changes in the workflow of the cytologist due to the introduction of telepathology. These changes occur in two stages. The first is the use of telepathology as a support methodology using external providers (i.e. outside the hospital) to digitize the slides. The second is the use of telepathology in routine laboratory operations using an internal scanner to digitize the slides. To improve courses in the Master of Cytology programme at the University of La Sapienza, new learning modules were designed, which were made available via the wide area computer network to familiarize students with the new technologies. The new methodologies had three benefits. The first was the high level of knowledge for the student. The second was the cost advantage to the student, who did not need to study in a medical laboratory to participate in the teaching. The third was the cost advantage to the hospital: as laboratories become freed from academic work, they become more available for clinical use.

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Motivation: This study deals with the introduction of artificial intelligence (AI) in digital pathology (DP). The study starts from the highlights of a companion paper. Objective: The aim was to investigate the consensus and acceptance of the insiders on this issue. Procedure: An electronic survey based on the standardized package Microsoft Forms (Microsoft, Redmond, WA, USA) was proposed to a sample of biomedical laboratory technicians (149 admitted in the study, 76 males, 3 females, mean age 44.2 years). Results: The survey showed no criticality. It highlighted (a) the good perception of the basic training on both groups, and (b) a uniformly low perceived knowledge of AI (as arisen from the graded questions). Expectations, perceived general impact, perceived changes in the work-flow, and worries clearly emerged in the study. Conclusions: The of AI in DP is an unstoppable process, as well as the increase of the digitalization in the health domain. Stakeholders must not look with suspicion towards AI, which can represent an important resource, but should invest in monitoring and consensus training initiatives based also on electronic surveys.