Making an impact

With USCAP 2023 in full effect I wanted to take minute and thank everyone for their support and encouragement. In this industry I’ve become known as a team player, a good listener, and someone who’s on a mission to help pathologists improve their patients’—and their own—quality of life. My hope is that the last 25 years working in surgery and pathology has laid a solid, quality foundation for this mission.

Throughout my career I worked alongside surgeons, pathologists, and laboratory professionals in African countries such as Rwanda, Uganda, Nigeria, Angola, and Ethiopia. Each of these experiences has left an indelible mark on me. They provided me with new insights for establishing a successful company in the US while collaborating with and empowering doctors in Africa. My collaborations with multiple vendors and non-profit organizations in these countries have shown me the harsh realities in healthcare, like cancer and its impact on patients and their families. 

Whenever I visit Africa, I’m overwhelmed by the pain and suffering that the people there endure daily. It’s heart-wrenching to witness a mother waiting three and a half hours for her nephew to fetch water before she can wash her children, make breakfast, wash clothes, feed herself. I see acres upon acres of shanty towns, where people merely exist—with no access to the clean water or basic tools that might make their lives livable. And as I move from destination to destination, each person, each hospital, seems to have more pressing needs than the last. 

The Gini Index gap shows that wealth inequality is a significant global problem. The top 10 countries with the highest wealth inequality are located in Africa. Those of us in wealthier countries live in a world of constant communication and social media—that often presents an unrealistic depiction of our world. Our online content portrays excesses of luxury that are beyond the reach of most of this planet’s residents. 

Despite our abundance, countless people continue to suffer needlessly. Many humanitarian workers travel to Africa with a desire to help everyone but feel powerless when they see firsthand the scale of misery. What one person can accomplish is just a drop in an ocean of suffering.

I haven’t seen all of Africa yet, but I’ve seen much of it. In my view, the global issue we should be most concerned with is inequality. That, my friends, is the superpower of digital pathology—it provides a way for individuals to multiply their impact. It can promote equality in healthcare by making cancer diagnostics more available. How amazing is it that a patient can go to a remote hospital in Rwanda and, using our technology, receive world class pathology services from Harvard University Medical Center in just three days? This should be a standard part of all our missions. 

Don’t get me wrong, it’s good that CPT codes are being improved and are being adopted by more and more providers. Even in our own backyard, underserved areas in Iowa, Ohio, Illinois, and Missouri are being helped today by digital pathology. Yet the need in the US pales in comparison to the need in Africa and other low- or middle-income countries (LMICs), where getting an accurate diagnosis is more difficult.

Many of you already know that I co-founded a new startup in pathology technology at the beginning of 2023. Its value to the field is that it aligns every aspect of diagnostic medicine succinctly and effectively, and in so doing, it enables us to improve medical systems, to make individual hospitals thrive, and to significantly enhance the quality of care for patients worldwide. Our company is now building its own diagnostic AI, and each day I look forward to being a part of this developmental leap in diagnostic medicine. Industry leaders have been warning us that diagnostic AI will be huge, and it will probably be more impactful in the rest of the world than it is here in the US, at least initially. In the US we have so many subspecialized pathologists that most regional hospital systems have at times questioned the value of digital pathology for increasing diagnostic yield. That mindset is waning as adoption increases, though it still persists among industry Luddites.

AI is creating change across the entire landscape of healthcare. Such a fast pace of change is unusual for this industry, to say the least. Veritable gold standards of medicine are being re-written because of data-driven algorithms. Have you heard enough times now how AI will change everything?

But let me ask you another question: Have you ever deployed AI in Africa? That’s where AI is needed most. That’s where an AI platform will make the most impact. Not only can pathologists use it as a diagnostic tool, but it provides artificial peer review, virtual differentials—a robotic peer that can be the sub-specialist for the general pathologist. Yes, I want the benefits of bringing digital pathology and diagnostic medicine to market here in the United States, but I can’t help but believe the greatest impact will occur in LMICs. 

When we think about dedicated medical devices and diagnostic algorithms, the US is still the gold standard in healthcare—despite the negative press surrounding our system’s weaknesses. Global international companies are clamoring to get FDA approval on as many of their devices as possible. The FDA’s blessing guarantees a boost to sales and partnerships in markets across the world.

As US medicine progresses with its astounding advances, I can’t help but think how much bigger the impact will be in Africa once our AI becomes operational.

What else can we do besides bring digital pathology and diagnostic AI to laboratories in LMICs? We can all give some of our time and resources. As I look around my circle of friends, family, and colleagues, it’s no surprise that we have more resources than do most people in this world. 

A few years ago, I was implementing digital pathology in Lagos, Nigeria, when I met a young hospital morgue assistant. This young man struck me as someone who could use help—someone who would amplify any help given to him 10-fold. Through our conversations, I looked for ways to help him, even if all it came to was giving him a Jackson to buy himself a few nice dinners. Luckily, we drummed up a much bigger project. Utilizing his talents, I arranged for him to create a video showing how digital pathology had helped their community. It was a nice little project for us—but for him it was a project that netted four years of income in two weeks. 

Most of us who travel to Africa end up giving out a lot of money to people because we know the impact it will have on them. We can always give someone a hand-out. But as the saying goes, a hand-up is better. Trust me when I say that sometimes, money can buy happiness. 

Since meeting that young morgue assistant and working with him, I’ve found other opportunities for him to grow further, to where he might be able to begin having what we’d flippantly call “a life.” When I met him, he lived in squalor, fighting off the biting rats throughout the night, losing those battles and having to sleep in the morgue… Shortly after I met him, he lost his mother too. I made a decision to “adopt” him, professionally, and I want to see him grow and prosper. We have a histology class coming up in Uganda this year. I’ll be sending him to this class so he can learn histology and become even more valuable to his hospital in Nigeria. With his potential, who knows where he could end up? And he’s not alone—there are many out there who we can encourage, engage with, and even teach more histology to. There’s a shortage of quality histotechs in this world. Let’s make more of them.

And finally, let’s do even more this year. I want to bring digital pathology to even more hospitals in LMICs. If anyone is reading this and wants to engage and bring these tools to more patients and across more sites, please reach out. Let’s make it happen. Meanwhile, I’ll continue to keep everyone posted about our work. Thank you all for your encouragement and support. We exist to make your pathology practice thrive, wherever you may be.

Scott