Identifying Missing Ingredients: Baking Your Business Case for Digital Pathology Investments


Background: In several regions around the world, digital pathology investments have led to fully digital workflows based on sound financial decision making.  However, in the U.S., we struggle to identify the most fundamental aspects of business justifications.  Providers are not always versed in business planning, analyses or pitching.  However, a sound financial model is needed to justify most clinical implementations of digital pathology.  Vendors often attempt to help with Return on Investment tools but lack the knowledge of our organization’s priorities, challenges and strategic plans.  We will discuss why Baylor College of Medicine invested in our digital transformation and how we plan to continue to build novel new revenue streams to build a long-term sustainable growth business.  Our core goal will be to help the audience consider their own organization’s guiding financial principles for a digital pathology investment.

Methods: In 2021, The Baylor College of Medicine installed 10 validated slide scanners for clinical sign out.  Our annual case volumes are about 20,000 and slide volume in 2022 was about 120,000.  The sizing of our slide scanner bank was based on our goal to achieve 100% capacity.  We calculated our additional digital pathology staffing resource expenses and  measured operational costs.  We invested heavily in IT infrastructure.  On January 30th, 2023, we went live with our digital pathology program.  For this study, we mapped our original business case and ROI calculation including cost savings and new revenue streams to our initial 6 months of realized implementation costs.  We will outline the key cost saving and revenue plans which include our anticipated use of our vast research repository.

Results: Baylor College of Medicine has measured our investment supporting the large-scale digital pathology implementation.  We will compare our projected business planning estimates with our actual investment.  We will highlight areas of variation which were both more and less expensive than anticipated.  We will share areas of particular interest to the audience planning to implement a large scale digital pathology program.  We will provide key recommendations and pitfalls to avoid based on our quantified results.

Conclusions: It is critical for groups to consider the fiduciary duties they have to their organizations when considering major investments.  Digital pathology has a number of benefits which are both quantitative and qualitative; advantages in patient care, communication and, of course, financially.  We will help organizations answer questions they may have about investing in digital pathology while sharing our findings from the first draft of a business case, through the initial capital purchases to the ongoing investments. 

Just as one plans the baking of a cake from the recipe to gathering ingredients, the mixing bowl to the oven to the cooling rack, we will describe the steps we have taken to make the business of digital pathology as palatable as possible. 



  1. Build Business Case for Digital Pathology Investments
  2. Learn what resources are required for successful Digital Pathology Implementations
  3. Understand Digital Pathology benefits - quantitative, and qualitative: advantages in patient care, communication and, of course, financial


Presented by:


Sunil Singhal, MEE

Chief of Digital Pathology Transformation

Baylor College of Medicine


A computer scientist by training, Sunil Singhal is an entrepreneur, product builder and management consultant. He is a broad thinker who excels at finding elegant collaborative solutions to problems that enhance the human experience. He has over 30 years of c-suite management consulting experience covering multiple industries. Sunil currently serves as the Chief of Digital Pathology Transformation at Baylor College of Medicine. He is experienced in formulating and implementing Digital Pathology strategy to support clinical, research and education missions. He has managed successful implementation of Digital Pathology programs at The Ohio State University, West Virginia University, and Baylor College of Medicine. He is interested in digital pathology workflow, image analysis, data analytics and computational pathology. Sunil has bachelor’s degree in Electronics and Communication Engineering from Indian Institute of Technology, Roorkee, India; and a master’s degree in Electronics Engineering from Netherlands.