The Un-Automatable Attributes of Histologists: Decision Making, Planning, and Resourcefulness

Industry Topics histologists, histology automation, histology workflow

The Un-Automatable Attributes of Histologists: Decision Making, Planning, and Resourcefulness

The word “automation” can be intimidating, especially when used to describe a task you do every day in your career. For many people, automation conjures up images of robots stealing jobs. Histologists have expressed similar worries when talking about the various steps of the histology slide preparation process that could be automated.

But Bonnie Whitaker, Anatomic Pathology Operations Director at the Department of Pathology at The Ohio State University – Wexner Medical Center, doesn’t think histologists need to worry about automation. “So many people worry with automation coming into the field – are they going to be displaced, are they going to get laid off,” Whitaker stated in an interview with Aquaro. “I’ve been in the laboratory now for 40 years and I’ve never seen anyone get laid off due to automation. Automation allows you to do things your lab couldn’t do in the past.”

Why do histologists appear to be resistant to job loss due to automation? As one report states, “The hardest activities to automate with currently available technologies are those that…apply expertise to decision making, planning, or creative work.” This means that the role of the histologist requires many characteristics that are not easily automated. When a histologist grosses a sample, chooses a control tissue, sets up a special stain, or conducts any number of tasks that require expertise and judgement, they are doing that kind of decision making and planning that cannot be automated.

The skills of decision making, planning, and creativity will become even more important for histologists in the future. One example of this is in the increasing use of multiplex immunohistochemistry (IHC), which requires both the knowledge and creativity of histologists. In a webinar last year, “Multiplexing on Animal and Xenograft Tissue All Things Considered,” LaToya Jackson, HT (ASCP), QIHC of the Henry Ford Health System illustrated the skills that make histologist knowledge vital and unreplaceable by automation. “If the targets are localized in different parts of the cell, then the chance of multiplexing is high,” stated in her introduction to multiplexing on xenograft tissue. “The trouble comes in when two targets are expected to show staining in the same part of the cell. It would be difficult to visualize, image, and analyze one cell that stain multiple colors in the same area. So we have to do our due diligence before we do anything else by analyzing if these targets can even be stained together. So sometimes it takes a bit of creativity to make things work the way we want them to.” Multiplexing is not the only histology task that requires these qualities; IHC, molecular pathology, and finding specific features in tissues are some of the other tasks that will require histologist experience and skills.

Given the immense value of the skills and experience gained to make judgements it is hard to imagine a piece of automation that could replace the histologist. Automation, however, does have a place in steps of the histology workflow that are mundane and don’t require as specialized skills. When repetitive tasks are offloaded to automated equipment, histologists are free to spend more of their time on tasks that require their experience, judgement, and creativity. In fact, automation of repetitive tasks can come as a relief as it appears that skilled histologists remain in high demand.

Automation can also standardize the quality of histology slides, enhancing the steps that histologists spend their time on, such as stains (all histologists know, “garbage in, garbage out”). For example, automating microtomy can make section thickness more consistent, directly affecting stain quality and patient diagnosis.

As Bonnie Whitaker stated above, automation lets histologists do things they couldn’t do in the past. In fact, tasks that are monotonous and boring should be automated, enabling histologists to use their unique skills to solve interesting problems and work on more analytical and creative tasks.