The Department of War (DoW) and Department of Veterans Affairs (VA) are accelerating digital pathology through coordinated infrastructure, policy development, and joint efforts in artificial intelligence. This presentation highlights three major initiatives that reflect increasing collaboration between these federal healthcare systems. The VA and DoW are partnering to retrieve and indefinitely store millions of archival pathology blocks and slides from VA medical centers across the country. These specimens, dating back 10-20 years, are linked to electronic health record data and represent a racially and geographically diverse population treated within an equal-access healthcare system. They are currently being transferred to the DoW's Joint Pathology Center (JPC), where they support clinical decision-making and can also be digitized to serve as foundational datasets for training and validating machine learning algorithms. In addition to this VA-exclusive collection, the JPC maintains a separate archive of consultation cases from both the DoW and VA. Together, these resources constitute one of the most comprehensive and valuable datasets available for the development of AI in pathology, distinguished by their diversity, scale, and consistent expert review. To support responsible data use, the DoW has implemented a data-sharing policy that defines the conditions under which digital pathology and imaging data can be accessed for research. The VA is adapting this framework to include other imaging modalities such as radiology, with the long-term goal of establishing a unified, multi-agency policy that supports secure and ethical data sharing. Both agencies are also rapidly building digital pathology infrastructure. The VA is deploying digital workflows for primary diagnosis, tumor boards, and quality improvement, while the DoW is operating a high-throughput scanning pipeline that processes up to 160,000 slides per month. With over 5.5 million slides digitized to date, the DoW has already used select datasets to train prototype AI models, including a prostate cancer algorithm for detection, grading, and prognostication. These collaborative efforts demonstrate how federal synergy can produce scalable, high-quality, and clinically impactful digital pathology solutions across national healthcare systems.

Learning Objectives: 

1. Describe how VA-DoW collaboration is enabling the retrieval, storage, and use of archival pathology materials to support clinical care and machine learning.
2. Identify the key components and challenges of developing secure, multi-agency data-sharing policies that facilitate AI innovation in federal healthcare.
3. Evaluate the digital pathology infrastructure in the VA and DoW, including scanning operations, telepathology services, and real-world AI applications.