In some parts of the world, reading samples from a glass slide is becoming the exception for pathologists. In these areas, digital workflows for pathology have become routine, and AI tools have become operational rather than experimental. Now, this level of adoption for digital pathology is starting to gain momentum in the US.
While adoption is expanding, the market remains formative. US healthcare organizations are navigating foundational decisions around image management systems, scanning infrastructure, and AI integration—often for the first time. In a recent report titled Digital Pathology 2026: Early Adoption & Technology Performance in an Emerging US Market, KLAS examined how organizations’ early experiences are shaping the next phase of digital transformation. Read on for insights into this report and the US digital pathology market.
Global Organizations Have Paved the Way, and the US Market Is Accelerating
In several regions around the world, particularly parts of Europe such as France and the Netherlands, adoption of digital pathology is significantly more mature than it is in the US. Broader regulatory clearances, centralized health systems, and earlier enterprise deployments have allowed many organizations outside the US to make digital workflows standard practice. In some markets, primary diagnosis using digital slides is no longer novel—it is expected.
As mentioned, the US is still building toward that reality; fewer than 15% of US healthcare organizations are at some stage of deployment with a digital pathology solution. Even among these early adopters, full digital conversion is uncommon. Larger organizations often report that less than half of their total histopathology case volume is read digitally, highlighting the operational complexity of scaling across multiple sites, subspecialties, and pathologists. And for most, cytology adoption is still on the distant horizon.
In this emerging market, partnership models, integration flexibility, and implementation strategy may matter as much as core product performance.
Purpose-Built Platforms Are Resonating in an Emerging Market
Vendors that offer image management systems (IMS) tend to fall into two broad categories: those that entered digital pathology from broader imaging or radiology backgrounds and those that built their solutions specifically for pathology workflows.
Early feedback suggests that pathology-specific platforms are resonating strongly with customers. Organizations frequently cite close collaboration, hands-on implementation support, and strategic evaluation of pathology workflows as key differentiators. In an emerging market, partnership appears to matter just as much as product functionality.
That said, healthcare organizations report opportunities for improvement for even the highest-rated vendors; these opportunities often relate to improved workflow efficiency, expanded functionality, integration enhancements, or a quicker development pace. This reflects the reality that digital pathology workflows are still evolving, and vendors and healthcare organizations alike are learning what “good” looks like at scale.
For organizations evaluating IMS solutions, this reinforces an important lesson: selecting a platform is not just about current features. It’s about long-term road map alignment, integration flexibility, and the vendor’s ability to guide change management through what can be a significant operational transformation.
Scanner Performance Remains Foundational to Success
Scanners continue to play a central role in shaping digital pathology experiences. Reliability, throughput, image quality, and service responsiveness are consistently cited as major drivers of satisfaction—or dissatisfaction.
Leica Biosystems stands out as the most widely adopted for clinical use in the US, with customers highlighting scan quality, efficient slide loading, and strong day-to-day reliability as meaningful productivity enablers. At the same time, budget constraints and cost considerations limit some customers’ ability to expand deployments as quickly as they would like.
Other scanner vendors are gaining traction, particularly among organizations seeking flexibility across different IMS environments. However, scaling for high-volume primary diagnosis remains a challenge with some solutions, especially when reliability or service support falls short.
As organizations move from pilot and early adopter phases to enterprise-wide deployment, scanner stability and vendor responsiveness increasingly separate early success stories from stalled initiatives.
AI Interest Is Growing, but Integration Is Non-Negotiable
Perhaps the most forward-looking insight in this year’s report is the growing interest in AI. Early adoption is concentrated in clinically focused use cases, particularly breast and prostate cancer applications. Breast biomarkers such as Ki-67, HER2, estrogen receptor (ER), and progesterone receptor (PR) are frequently mentioned targets for AI, signaling a desire to enhance consistency and efficiency in high-impact diagnostic areas.
However, one theme rises above the rest: integration matters. Healthcare organizations consistently emphasize that AI must function within existing IMS workflows rather than as a separate system. Pathologists do not want to toggle between platforms or disrupt established processes. Instead, they expect AI to embed seamlessly into routine diagnostic operations. In other words, AI’s success in digital pathology will depend less on algorithm novelty and more on workflow orchestration.
Limited Data Today, Significant Implications Tomorrow
A defining characteristic of this market is its nascent status. No IMS vendor in this report has yet reached the sample sizes that KLAS typically requires for software solutions to be considered fully rated (i.e., 15 unique organization respondents), and thus many solutions in the report are marked as limited or emerging data.
This is not a weakness of the research—it is a reflection of the market’s stage of development as most vendors have yet to reach 15 live clients. In an emerging ecosystem, small customer bases mean that perceptions can shift meaningfully as more organizations go live and scale. Buyers should view current performance trends as directional signals rather than fixed conclusions.
At the same time, early insights are invaluable. They reveal which vendors are building trust, where workflow friction persists, and how organizations are thinking about long-term digital transformation.
The Path Forward
Adoption of digital pathology in the US is crossing an important threshold; AI interest is accelerating, and organizations are moving from isolated pilots to broader clinical integration. Yet this is still a formative stage—one where partnership, integration, and operational discipline matter deeply.
For healthcare leaders evaluating digital pathology solutions, the key questions are no longer if digital workflows will expand but how to implement them sustainably and strategically.
Our full Digital Pathology 2026 report provides deeper analysis of vendor performance, customer experiences, scanner satisfaction, and AI market energy. We encourage you to explore the complete findings to better understand how this emerging market is evolving and what it means for your organization’s next steps.
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