Introduction/Background: Digital pathology has transformed microscopic diagnosis, yet the gross room remains comparatively less digitized. Despite its critical role in staging and diagnosis, gross examination still relies heavily on manual tools and subjective estimation, impacting efficiency, reproducibility, and patient care. The 'state of gross pathology technology' initiative was developed to evaluate emerging technologies and define a framework for understanding adoption and workflow integration.

Methods/Design: This work describes a report framework integrating clinical workflow observation, engagement with practitioners across diverse settings, and discussions with industry stakeholders. Technologies include specimen imaging, digital grossing workstations, and reporting platforms. Exploratory development of small computational tools was used to assess support for tasks such as measurement and estimation. Planned next steps include broader practitioner surveys, including community and resource-limited settings.

Results: Preliminary observations suggest increasing availability of digital infrastructure, particularly in imaging and workflow integration, with variable adoption across institutions. Many tasks remain manual, contributing to cognitive load and variability. Early exploration indicates computational tools may improve consistency, reduce repetitive workload, and support structured data capture, with potential impact on workflow efficiency and timeliness of care.

Conclusion/Discussion: The report provides a framework for understanding how the gross room may evolve through scalable infrastructure and workflow-integrated innovations. Emphasizing diverse practice settings, clinician involvement, and interoperability will be essential. Advancing digital grossing has the potential to reduce practitioner burden and support more consistent, high-quality patient care.

Learning Objectives:

1. Describe trends in digital grossing and their impact on workflow and patient care
2. Explain how diverse practice settings influence technology adoption in gross pathology
3. Identify strategies for implementing scalable digital grossing solutions