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Speed, accuracy, and efficiency: The promises and practices of digitization in pathology

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  • Kusta, Olsi
  • Bearman, Margaret
  • Gorur, Radhika
  • Risør, Torsten
  • Brodersen, John Brandt
  • Hoeyer, Klaus

Abstract

Digitization is often presented in policy discourse as a panacea to a multitude of contemporary problems, not least in healthcare. How can policy promises relating to digitization be assessed and potentially countered in particular local contexts? Based on a study in Denmark, we suggest scrutinizing the politics of digitization by comparing policy promises about the future with practitioners’ experience in the present. While Denmark is one of the most digitalized countries in the world, digitization of pathology has only recently been given full policy attention. As pathology departments are faced with an increased demand for pathology analysis and a shortage of pathologists, Danish policymakers have put forward digitization as a way to address these challenges. Who is it that wants to digitize pathology, why, and how does digitization unfold in routine work practices? Using online search and document analysis, we identify actors and analyze the policy promises describing expectations associated with digitization. We then use interviews and observations to juxtapose these expectations with observations of everyday pathology practices as experienced by pathologists. We show that policymakers expect digitization to improve speed, patient safety, and diagnostic accuracy, as well as efficiency. In everyday practice, however, digitization does not deliver on these expectations. Fulfillment of policy expectations instead hinges on the types of artificial intelligence (AI) applications that are still to be developed and implemented. Some pathologists remark that AI might work in the easy cases, but this would leave them with only the difficult cases, which they consider too burdensome. Our particular mode of juxtaposing policy and practice throws new light on the political work done by policy promises and helps to explain why the discipline of pathology does not seem to easily lend itself to the digital embrace.

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  • Kusta, Olsi & Bearman, Margaret & Gorur, Radhika & Risør, Torsten & Brodersen, John Brandt & Hoeyer, Klaus, 2024. "Speed, accuracy, and efficiency: The promises and practices of digitization in pathology," Social Science & Medicine, Elsevier, vol. 345(C).
  • Handle: RePEc:eee:socmed:v:345:y:2024:i:c:s0277953624000947
    DOI: 10.1016/j.socscimed.2024.116650
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    References listed on IDEAS

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    1. Siala, Haytham & Wang, Yichuan, 2022. "SHIFTing artificial intelligence to be responsible in healthcare: A systematic review," Social Science & Medicine, Elsevier, vol. 296(C).
    2. Christiansen, Terkel & Vrangbæk, Karsten, 2018. "Hospital centralization and performance in Denmark—Ten years on," Health Policy, Elsevier, vol. 122(4), pages 321-328.
    3. Morley, Jessica & Machado, Caio C.V. & Burr, Christopher & Cowls, Josh & Joshi, Indra & Taddeo, Mariarosaria & Floridi, Luciano, 2020. "The ethics of AI in health care: A mapping review," Social Science & Medicine, Elsevier, vol. 260(C).
    4. Petr Holub & Heimo Müller & Tomáš Bíl & Luca Pireddu & Markus Plass & Fabian Prasser & Irene Schlünder & Kurt Zatloukal & Rudolf Nenutil & Tomáš Brázdil, 2023. "Privacy risks of whole-slide image sharing in digital pathology," Nature Communications, Nature, vol. 14(1), pages 1-15, December.
    5. Onno, Julien & Ahmad Khan, Faiz & Daftary, Amrita & David, Pierre-Marie, 2023. "Artificial intelligence-based computer aided detection (AI-CAD) in the fight against tuberculosis: Effects of moving health technologies in global health," Social Science & Medicine, Elsevier, vol. 327(C).
    6. Green, Sara & Carusi, Annamaria & Hoeyer, Klaus, 2022. "Plastic diagnostics: The remaking of disease and evidence in personalized medicine," Social Science & Medicine, Elsevier, vol. 304(C).
    7. Carboni, Chiara & Wehrens, Rik & van der Veen, Romke & de Bont, Antoinette, 2022. "Conceptualizing the digitalization of healthcare work: A metaphor-based Critical Interpretive Synthesis," Social Science & Medicine, Elsevier, vol. 292(C).
    8. Neumark, Tom, 2023. "Digital diagnostics from Tanzania: Beyond mere technological fixing?," Social Science & Medicine, Elsevier, vol. 319(C).
    9. De Togni, Giulia & Erikainen, Sonja & Chan, Sarah & Cunningham-Burley, Sarah, 2021. "What makes AI ‘intelligent’ and ‘caring’? Exploring affect and relationality across three sites of intelligence and care," Social Science & Medicine, Elsevier, vol. 277(C).
    10. Gross, Sky, 2009. "Experts and 'knowledge that counts': A study into the world of brain cancer diagnosis," Social Science & Medicine, Elsevier, vol. 69(12), pages 1819-1826, December.
    11. Ziebland, Sue & Hyde, Emma & Powell, John, 2021. "Power, paradox and pessimism: On the unintended consequences of digital health technologies in primary care," Social Science & Medicine, Elsevier, vol. 289(C).
    Full references (including those not matched with items on IDEAS)

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