Transcript
Torbjørn Thomsen: All right, and we're live. Okay, so um today we're talking to Dr. Raji Lakshmi. She's the co-founder of PathIQ, and they're building a software to kind of modernize how pathologists work within cancer care, sort of like faster diagnosis, better collaboration, less friction.
Torbjørn Thomsen: um That's a very... it's a very hard problem in a very conservative industry, right? And so i kind of wanted to start with Raji, whenever you guys were first starting out and building this, like what, what turned out to be harder than you had initially thought it would be?
rajalakshmi: Yep.
rajalakshmi: So what happened was, ah as you know, I am a pathologist. So I am in this field of pathology.
Torbjørn Thomsen: Yeah. Uh huh.
rajalakshmi: And the CEO and founder of Path IQ Intelligence, that is Rahul Vasnik, he is into tech. So he is in the technological technology field.
rajalakshmi: So what happened was, ah what got us thinking was that pathology isie as a science is incredibly advanced. But we are still dependent on some fragmented workflows or something which is inefficient.
rajalakshmi: The workflows are inefficient. And as pathologists, we are doing repetitive manual work, which is instead of focusing on that, we could focus on give more attention to the patient's clinical diagnosis.
rajalakshmi: So that was what got us thinking. And then so we thought, OK, let's build a software. A good software should decrease the cognitive load of the doctor and not increase it.
rajalakshmi: So what happened was we were like, we saw that so many highly expert professionals are spending so much of their mental strength in our print you're figuring out the workflows and then doing things which the software can do it easily.
Torbjørn Thomsen: Yeah.
Torbjørn Thomsen: Yeah.
rajalakshmi: could do it easily and so you know in a simplified manner so we thought okay so it started out like that it's not like oh let's build a startup it's more like why is this so hard why is this so difficult let's make this easier so that's how we started it so yeah so we found out that
Torbjørn Thomsen: Yeah.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: As a system, since pathology, we've been following it. Why are we, when all the fields of medicine is advancing at a faster pace, why are we still stuck on old ancient methods of, you know, staining the slide or cutting the slide or viewing the slides under a microscope? Why should it be limited to a single lab?
rajalakshmi: Why should we limit our resources and our learning to a single lab when we could, you know, ah go out and, you know, anyone could collaborate.
rajalakshmi: Anyone, like a case I could see today, someone else can see it in any other part of the planet.
Torbjørn Thomsen: Yeah.
rajalakshmi: It could be a learning experience for them. So this is something which is lacking, which is lacking and it's highly restricted or to a certain infrastructure or geography. So that is something which we felt like it's it shouldn't be that way.
rajalakshmi: So that was something which was like really hard for us. But ultimately we have this, like we are so excited to introduce this PathIQ intelligence system.
rajalakshmi: And we are releasing the first version of the mobile PathIQ app. So on the phone. So when you have if you have a smartphone, you can view whole slide images you can collaborate with other physician be it any physician or a resident or a pathologist or an educator be it a researcher or any lab can we all come together we can collaborate and you know explore it challenge it and then yeah the we we feel free to share the feedback to us so the mobile app version is launching soon so yeah
Torbjørn Thomsen: Yeah. Yeah.
Torbjørn Thomsen: Wow.
Torbjørn Thomsen: Okay, and you've you've been purely web based up until now.
rajalakshmi: Yes.
Torbjørn Thomsen: Yeah.
rajalakshmi: So the whole system is that we want the software to be something which ah which can be accessible to anyone in anywhere, in any part of the world.
Torbjørn Thomsen: Mm hmm.
rajalakshmi: you know So let's not be restricted to a certain place or let's not be restricted to a certain ah kind of platform. For example, some LIS or the lab information systems are used only for a certain ah you know speciality of medicine. So we don't want that.
rajalakshmi: Let every everyone access it. Let it be accessible to everyone. Let it be a learning platform for everyone, including students. So that's another thing.
Torbjørn Thomsen: Very nice.
rajalakshmi: Yeah.
Torbjørn Thomsen: Yeah, that's a huge thing. hey Like access to both physicians and labs is is a big thing. um I would like to just before we go deeper, because there's a lot there, which is awesome. um I think a lot of people, including myself, to be honest, we don't probably don't fully understand exactly like what does a cancer pathologist do exactly? Could you just quickly just go through that in two minutes? Just explain that to us.
rajalakshmi: Yes, yes, yes.
Torbjørn Thomsen: Yeah.
rajalakshmi: So pathology is one specialty of medicine where we are, it's a strong pillar, you know, like a crux. We form a crux between the diagnosis of the patient and the therapeutic decision that the clinician will take ah the towards the management and patient care.
Torbjørn Thomsen: Yeah.
rajalakshmi: So what happens is pathology has many divisions under it. So we have the histopathology, which deals with tissues. And any tissue diagnosis, we cut up, you know, organs or tissues and view micro, you know, we view it as slice under the microscope.
Torbjørn Thomsen: Right.
rajalakshmi: And then we have the cytopathology, which deals with the cells.
Torbjørn Thomsen: Right.
rajalakshmi: And we have the hematopathology, which deals with blood and so on.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So our main focus right now would be the histopathology.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: which deals with the tissue and it can be a tumor, it can be a non-tumor, it can be a benign or it can be a malignant specimen.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So anything, you you just cut the tumor to be, to tell in simpler words, we just, you know, cut the tumor and look in look under the microscope to help the clinician arrive at a diagnosis.
Torbjørn Thomsen: Yeah. Yeah.
rajalakshmi: And then in we it's it's also important in frozen sections where, you know, when a patient is being operated, they send a preliminary sample to us and then we evaluate whether the margins are accurate.
Torbjørn Thomsen: Yeah.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: or whether they need to resect more.
Torbjørn Thomsen: Yeah.
rajalakshmi: So that's another valuable thing that pathologists do. So what happens is ah most patients do not get to meet a pathologist, but we play a major role in the clinical decision making process ultimately.
Torbjørn Thomsen: Yeah.
rajalakshmi: Yeah.
Torbjørn Thomsen: Yeah. Yeah. So you're kind of you're working a lot behind the scenes basically.
rajalakshmi: Yes.
Torbjørn Thomsen: Yeah. Yeah. Okay. That's yeah. Good. Um, so, and you, you touched a little bit about this, but you're the specific kind of frustration and pathology that, that, uh, made you think like, we've got to do something different here.
Torbjørn Thomsen: Um, was that kind of the workflows or was it more the diagnostic what what what was it and how did that kind of shape what you built does that make sense
rajalakshmi: Yes. So what happened was, there's this thing that as a pathologist, so as a resident, I have seen that we are doing manual repetitive work.
rajalakshmi: Like, for example, in many labs, even now, the slides are manually labeled and then they're manually assorted for each pathologist to come and view them under the microscope.
Torbjørn Thomsen: mm-hmm Yeah.
rajalakshmi: So all those are such tedious work, which is totally unnecessary and we shouldn't be doing it in 2026. So this is something which is really something. So each minute which we save in the workflow is more attention to the patient, for the patient care so that we can focus more on patients.
rajalakshmi: And but there are certain softwares where you end up, you know, taking more time to understand and evaluate. It's it's not a doctor, you know, adjusting to the software. It's it should be the it should be the other way around.
rajalakshmi: The software should be adjusting to the doctor, if you know what I mean.
Torbjørn Thomsen: Right.
rajalakshmi: Like there are a lot of health care technologies right now.
Torbjørn Thomsen: Yeah.
rajalakshmi: I think they should dive deeper into a clinician's perspective so that it makes it easier for the clinician to access it.
Torbjørn Thomsen: Right.
rajalakshmi: And so that, you know, so that there are such brilliant doctors out there and we don't want them wasting their mental capacity and their time on something which a software could do easily.
Torbjørn Thomsen: Right.
rajalakshmi: So that was one thing.
Torbjørn Thomsen: Right.
rajalakshmi: Yeah. So that was one thing. One more thing is, ah there are so many rare cases which are available in different labs and then there's no you know it's it's all like there's unlimited potential out there which we can never know from another lab perspective so it's like we when when knowledge is accessible we that was the main reason we got we got the app on a mobile version so that the knowledge should not be constrained due to a geographical or an infrastructure perspective of barrier so it should be accessible to everyone so that was one of the main things we had and the second thing was that you know the uh
Torbjørn Thomsen: Right.
rajalakshmi: when a whole slide image is uploaded onto the server, it can be taken up to discussion and it can be sent to a highly specialized pathologist across the world if you have a doubt.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Right?
rajalakshmi: But you know what they used to do previously?
Torbjørn Thomsen: Right?
rajalakshmi: They used to actually manually label the slide, pack it, and then courier it to them
Torbjørn Thomsen: No.
rajalakshmi: to another lab and then they used to receive it, look into it under the microscope and then report it and then send it back. So all this is unnecessary. And what we're doing is there's there's a patient out there. each Behind each slide, there is a patient anxiously waiting for the diagnosis.
rajalakshmi: And this is something very crucial which we have to cut out and it's totally unnecessary.
Torbjørn Thomsen: Right. Right.
rajalakshmi: So that's another thing which we were really, so this was the vision behind
Torbjørn Thomsen: Yep.
rajalakshmi: Thank you.
Torbjørn Thomsen: Nice. I really, so I really liked the part about, um, cause it t systems figuring out it t systems is, and I don't think you know this if if you're not in healthcare, care that figuring out healthcare it t systems is is often horrible and it takes forever.
Torbjørn Thomsen: And, is a big part of starting somewhere new. It takes forever to learn the IT system. and It's a huge source of stress. um and And so I really like i really like that angle, kind of making it making that part easier because that's a massive thing.
Torbjørn Thomsen: And especially for adoption, right? and Adoption will be much easier if if you can get physicians using it easier and with less barrier to entry sort of.
rajalakshmi: Yeah, see as a pathologist as well, we are spending so much time switching between the LIS, EMS and the scans of the patient and the patient's previous history and the reports and data and whatnot.
Torbjørn Thomsen: very interesting. Mm-hmm. Mm-hmm.
rajalakshmi: So all this can be resolved if there's a single platform which can give you all the patient's details, the gross specimen reports, and you can draft reports map You can draft reports we using the templates.
rajalakshmi: And then we are, you know, as a resident, we used to copy, paste the templates and paste the reports and manually edit it over and over again to arrive at a final diagnosis.
Torbjørn Thomsen: Mm-hmm. Okay. Yeah.
rajalakshmi: So all that is so tedious. And then if you have a software which is, e you know, which lags or which lags something in a certain way,
rajalakshmi: It's adding more stress to the doctor, to the clinician and to the patient as well. So that should be something to be tackled in 2026 at least.
Torbjørn Thomsen: yeah
rajalakshmi: Yeah.
Torbjørn Thomsen: yep And so you're also building, so you're there's the whole workflow thing, right? And then there's the there's the there's the knowledge bank because what it normally is is that if you have some rare disease on ah on a microscope slide, you only have it in one specific lab and no one else can see it, right?
Torbjørn Thomsen: Which is... something that would be massive for education to be able to see all these different slides of different things, because that's a lot of what, well, my idea of pathology, there's a lot of, is there a lot of pattern recognition?
rajalakshmi: Yeah.
Torbjørn Thomsen: Is that right?
rajalakshmi: Yes, they do. Yeah.
Torbjørn Thomsen: Yeah. And so having these, having seen these patterns before, it's just a massive thing.
rajalakshmi: Yeah.
Torbjørn Thomsen: is the
rajalakshmi: So what happens is like as a resident, I know that from my perspective, we had scattered towards study material. We all had scattered study material like for some certain topics. We are like, OK, refer to this thing for a certain topic, refer to this thing this or by this by this author.
rajalakshmi: So and so on. So what happens is when you have a single growing library of all the real slides and rare cases, including the regular ones,
Torbjørn Thomsen: Yeah.
rajalakshmi: It becomes easier as a resident to, you know, access each and every one of them and then so that they can be more confident and better. And we even have the option where you can annotate and then take snapshots of it and send it across or save it.
Torbjørn Thomsen: Right?
rajalakshmi: So that makes it more easier ah from a resident's perspective as well.
Torbjørn Thomsen: And so does the the AI part of it, does that come in as part of the pattern recognition or where does that come in?
rajalakshmi: So right now, the AI assists. For example, AI can assist in counting the number of cells or of recognizing a certain pattern.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: Or, you know, if if there is a certain region of interest, it can map it. And there's a heat map as well, analysis as well.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: But these are ah la restricted right now because, you know, if there's a learning curve for the AI as well. As the number of cases increase, it's like a vicious cycle. As the number of cases increases, as the data increases, AI has more and more power and it's a growing loop for ai as well.
rajalakshmi: So when more and more cases are, comes into the platform, AI can grow and, you know, can get better at it over time.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Yeah. Uh-huh.
rajalakshmi: So, yeah, so that's one more thing.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: And some people think that, okay, oh, AI is here. So, you know, what, what about our jobs and, you know, oh, AI, will AI replace pathologists and stuff like that.
Torbjørn Thomsen: Right?
rajalakshmi: So that's another valid point. So the thing is, AI is here to assist us and to give us better tools so that we don't waste time doing, you know, manual tasks.
Torbjørn Thomsen: Mm-hmm. okay
rajalakshmi: And let us focus more on, you know, were getting a proper diagnosis for the patient.
Torbjørn Thomsen: yeah
Torbjørn Thomsen: and
rajalakshmi: So what happens is like AI can, ah you know, AI can stay in AI can do so many things virtually. But what AI lacks is that AI lacks the judgment.
rajalakshmi: AI lacks ethics. So that's where a pathologist comes in. So the pathologist with his experience and with his knowledge and expertise can arrive at a diagnosis. So AI assists and the pathologist ultimately decides the diagnosis.
rajalakshmi: So that is what we are bringing about in this Path IQ.
Torbjørn Thomsen: Is that kind of because that that kind of touches on my next thing here, which is the trust from pathologists especially, but also other people in the industry. But and when you think about getting them to trust both AI, but also it programs and other people, basically, um what um what sort of had to happen for you to get pathologists to trust this? Have you have you gotten pathologists to trust it? How's that going?
rajalakshmi: Yes, we do. Yes, we do. Because see, AI does not have any role in the diagnostics. AI is just a soldier doing its job. You know, you go count yourselves or you, you know, try to recognize this pattern and game so that I am not wasting more of my time on doing something which, you know, when you know how, ah for example, this, this concept of mitotic figures.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So mitotic figures is something it's a cell, basically a cell when it's dividing.
Torbjørn Thomsen: Okay.
rajalakshmi: ah It goes into the state or a phase called the mitotic figures. It forms mitotic figures inside the cell. So this is, this represents the dividing capacity of a tumor.
Torbjørn Thomsen: Okay.
rajalakshmi: And it also it also has a huge role, huge, huge role in the staging of tumors.
Torbjørn Thomsen: Okay.
rajalakshmi: And this is an important part because it helps the clinician decide whether to go for surgery or to go for a conservative management or can we treat it chemo therapeutically or do we go for radiation. So it matters a lot. So this is just one small example wherein instead of see when I count the number of mitotic figures I might get a certain number and another pathologist wants the same slide for mitotic figures he might get a different number so that's called the inter-observer variability so we are avoiding this by giving the machine this particular task that okay you count the number of mitotic figures it it it has a certain neural neural connection so that it builds on patterns and then it gives a number
Torbjørn Thomsen: Yeah. Okay. yep
rajalakshmi: And you can always go back and, you know, you can always go back and do that manually as well.
Torbjørn Thomsen: And count it, yeah. so
rajalakshmi: So, yeah.
Torbjørn Thomsen: So basically you're, yeah, sorry.
rajalakshmi: So, when... but
Torbjørn Thomsen: if you're you're you're Just to make sure that I'm tracking here. you're You're basically, for this example, tracking how often a cancer cell is dividing.
Torbjørn Thomsen: And you can manually count that or you can have AI count that. And having a machine count can actually reduce the inter-variability between pathologists. So it it has basically less error.
Torbjørn Thomsen: Is that right?
rajalakshmi: Yes.
Torbjørn Thomsen: Perfect.
rajalakshmi: That is one small example, but there are a lot of things on a slide which we have to look for.
Torbjørn Thomsen: right.
Torbjørn Thomsen: Yeah.
rajalakshmi: And that is just a one part of it because there are other things as well. For example, now I have a slide in my lab which needs a second opinion by someone.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So what I do is, you know, as I already told you, because you need to manually send it and then do that and then talk to the other lab and things like that.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So now what happens is you just upload the slide from a particular lab onto the software. And this whole scanned scant slight image will receive will be received at the on the same platform by another lab.
rajalakshmi: and the And a pathologist from across the world can access the slide and then report it within minutes.
Torbjørn Thomsen: Right, you get the right
rajalakshmi: So that is, yeah, so that, yeah.
Torbjørn Thomsen: So you get the right pathologist to the right slide basically, right? You're kind of sort of connecting the two that, and the the that's kind of the workflow of thing you're solving, right?
rajalakshmi: Exactly, yes. yes
Torbjørn Thomsen: You're just kind of connecting the dots really with in a faster way, which is massive for patients and diagnosis.
rajalakshmi: Yes. Yes.
Torbjørn Thomsen: Uh, sometimes, especially with the, uh, like you were talking about with the frozen slides where people are actually on the table having surgery where you cut out the chunk of the tumor and send it down to the lab.
Torbjørn Thomsen: Why patients are still so under anesthesia and waiting for the diagnosis to see, did we cut out enough of this?
rajalakshmi: Yes.
Torbjørn Thomsen: Right. Like that's massive.
rajalakshmi: Yeah.
Torbjørn Thomsen: Um, right.
rajalakshmi: yeah
Torbjørn Thomsen: So there's, and it, there's a lot, you have a lot of passion for this. That's, it's very cool. And there's a lot of really,
rajalakshmi: Thank you.
Torbjørn Thomsen: um there it seems that there's a lot of um things that are very problems that are very obvious for you to see.
Torbjørn Thomsen: um
rajalakshmi: Yes.
Torbjørn Thomsen: So I'm wondering, like, was it, you have an example of something that looked really obvious from the outside, something that this is a great problem to solve, but it became really hard to solve in reality?
rajalakshmi: Yes, actually, one thing is the AI part of it, because many pathologists, as you said, many pathologists are obviously skeptical. Oh, what is, what you know, what if AI comes? And then, oh, why should why should we why should we depend on a certain machine or an AI?
rajalakshmi: Why should we, you know, trust you? Why should we trust AI?
Torbjørn Thomsen: Yeah. Right.
rajalakshmi: Like, why should we trust AI?
Torbjørn Thomsen: right
rajalakshmi: that was one huge thing which we had to overcome because, you know, But right now, I think there's an evolving and ever-growing, you know, ever-growing knowledge on digital pathology that it has come to a point where ah it's not AI versus pathologists.
rajalakshmi: It's pathologists who are ready to work with AI versus pathologists who are not ready to work with AI. So we've come to that point right now.
Torbjørn Thomsen: Right.
rajalakshmi: So that is a huge, you know, leap of, it's a huge leap.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: And I think, further going on, I think in the next decade, I think i the infrastructure or a certain lab or a geography will not be a matter anymore in the next few decades.
Torbjørn Thomsen: Yeah.
Torbjørn Thomsen: Yeah. Yeah, so that's where you're, yeah, because you're sort of, Basically, you could do what you're, you need people to make the slides, but, and put them under a microscope. But from there, you could do anything else remotely, basically. Right?
rajalakshmi: Yes, so what happens is um um we take care of everything once the slide is uploaded onto our system.
Torbjørn Thomsen: Right. Yeah.
rajalakshmi: So once the slide is prepared and processed, so after that the slide is scanned and the scanned images are uploaded onto the system.
Torbjørn Thomsen: Mm-hmm. Mm-hmm.
rajalakshmi: So after that we take care of everything after that. So the workflow is basically like the slide is there with us, so the slides will be triaged. So the urgent cases are the malignant, key potentially malignant cases or the tumor cases will go first and the other cases will go next.
rajalakshmi: But well within the turnaround time. And the next thing will be that the cases will be triaged in such a way that the cases go to a certain specialist only.
rajalakshmi: So for example, if there are tumors of the ovaries, so it's it better go to a gynecological pathologist. rather than a general pathologist or anybody else.
Torbjørn Thomsen: Right.
rajalakshmi: So we make sure that it goes that way.
Torbjørn Thomsen: Right.
rajalakshmi: And one more thing is labs have access to all the pathologists. They get to collaborate with any pathologist anywhere across the world. And as a pathologist, you get to collaborate with any other pathologist and any other lab as well.
rajalakshmi: and resident, you get to access all this growing library of you know a huge cloud library of slides and labs also have this problem of you know for storage.
Torbjørn Thomsen: Yeah.
Torbjørn Thomsen: Yeah.
rajalakshmi: There's certain storage problems as well because you can't, I have seen slides being stored for decades together and the slides are no longer accessible because this stain is faded.
rajalakshmi: The slides may be broken.
Torbjørn Thomsen: Okay.
rajalakshmi: So there are a lot of things with physical slides.
Torbjørn Thomsen: Okay.
rajalakshmi: There are a lot of limitations with physical slides. So it's it's better to be stored on a cloud platform with backup rather than just leave it physically.
Torbjørn Thomsen: Right. Right. It'll last longer, basically.
rajalakshmi: Yeah.
Torbjørn Thomsen: Yeah. Yeah. And so how, um how, when did you sort of come into this? did how far along in the process of building this did you sort of come into it?
rajalakshmi: We were very early, very early, in very early stages and this mobile app was not yet in our
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: You know, it was not yet in the idea. The main idea was that, okay, let us focus on a platform which could be accessible via a desktop or something like that.
rajalakshmi: But then we thought, okay, why not go further? Make it accessible on a smartphone anywhere across, any any anywhere. So that is that was one more thing. But we got into it in the very early stages. Like I got into this system very early.
rajalakshmi: And we were still, you know, planning to build from when how how the dashboard should look from a pathologist's point of view and how the lab comms should look.
Torbjørn Thomsen: Mm-hmm. Mm-hmm.
rajalakshmi: And we even option of messaging each other on the platform. So if I have a doubt on certain thing, I can send a snapshot over to you and then you can comment on it as well.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: And then I have an option to communicate with the labs that uploaded the image. So if I have a problem saying that, okay, the stain is not accurate or if I feel like I want another additional information,
rajalakshmi: um section of the slide so I can go to the lab comms and be like okay can I get an additional copy of this slide so then they can go back and they can send that thing as well so yeah we began there and now we are in this stage where we are very excited to release the mobile app version as well
Torbjørn Thomsen: OK, very cool. And so that a huge part of this is having a a network. right you have You need a network of pathologists, and you need at least some labs too. right um
rajalakshmi: Yes.
Torbjørn Thomsen: and you need the local lab sort of using it as well. How do you go about securing that network? What are you guys doing to expand that network? Okay.
rajalakshmi: Yeah, so right now we are in the stage where we have global path IQ ambassadors as well. We have a huge, great team of pathologists who are just waiting to, you know, put it out there and then go to labs, talk to labs and tell them that, okay, this, this, this. And so many labs have this problem of tackling for storage and they do have a problem or for the learning learning curve for the residents as well.
rajalakshmi: And they obviously they all have a problem for, you know, a second opinion. And that is something it's a pain. It's a pain really. So it will be a great um thing when when all the ambassadors just reach out to networks and we have already reached so many labs and they're very happy to, you know, go forward. And we are just waiting for everything to, you know, ah be more systematic and more organized on the network as well.
Torbjørn Thomsen: Do you have a number? Like how many pathologists do you have? a Do you have a number? How big is, how big is this? Do you have,
rajalakshmi: I'm not entirely sure right now, but I think it's not less than about 40.
rajalakshmi: polypathologists right now all are eager they're such a great team everyone is so enthusiastic and so eager to you know everyone is so excited that okay we have this platform and you know it's going to help so many people cut down so much of you know unnecessary tasks and you know previous procedures as well so yeah we are very excited
Torbjørn Thomsen: Yeah.
Torbjørn Thomsen: And so do you ever, do you ever come because there's a lot of actors on that platform, right? um Do you ever sort of come into disagreements about what pathologists need and what the lab needs and what the IT t can support and what the product team wants to build? Like, how do you sort of,
Torbjørn Thomsen: how do you How do you decide? Does that make sense?
rajalakshmi: Yes. To be honest, the tech support team has been so immensely, you know, they're so friendly and they're so open that and they're just like, okay, just tell me whatever you need.
rajalakshmi: Like whatever you need, what would make your life easier as a pathologist? Don't worry how it's going to work.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: you just You just throw me ideas. You just throw me things that makes your life easy. So we just like, you know, so we don't think much of the tech part of it. And then they are so accommodating and so lively and so cheerful. They are ready to accommodate any of our requests.
rajalakshmi: And that's a huge plus point because initially when we released it to a certain group of pathologists to, you know, to test out the platform.
Torbjørn Thomsen: Yeah.
rajalakshmi: We also got so much of you know positive feedback and then we also got certain ideas as to how we could improve it further.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So that's a huge advantage to us. So now right now we are building on that. And yep, let's see how it goes.
Torbjørn Thomsen: so how So how did you just, like, a very concrete, like, how did you test it out first? Like, did you did you reach out to a few pathologists and ask them, but, like, how what did you do to test it in the beginning?
rajalakshmi: So we conducted a pilot study which consisted of as up to 80 pathologists, 80 to 100 pathologists.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So what happened was we sent across the platform, the which was in the initial stages of the platform, which was working really well. So all we were concerned at that point was If it works just as a digital pathology platform and not anything else, forget about the workflow, forget about anything else.
Torbjørn Thomsen: Right. Mm-hmm.
rajalakshmi: Does it make your job easier? Does it make your life easier? So what we did was we sent across the platform. We sent across few slides as well for them. Scanned slides so that they could test it out, you know, play around.
rajalakshmi: Look how the dashboard is. Look how it feels. You know, get the feel of it. And then move around, annotate slides, try to send it to someone else, ah talk to someone on the platform and do things like that. And people were so happy and so excited about it that they would. And we conducted a study as well. Like we got their feedback in a systematic format and we analyzed it and, you know, ah got all the statistics part of it.
rajalakshmi: And we found out that up to 80% of pathologists are ready to use it in real world diagnostics. So that's like a huge revelation for us as well, because we always think that, oh, why are we still stuck in old times? Why are we still stuck? ah But pathologists are ready to accept it, ready to accept the newer technologies and are ready to work with it. And why are we still not building it?
rajalakshmi: So that it came up to that.
Torbjørn Thomsen: Right. And so the did you, to get those, to get that first 80 or a hundred pathologists, did you just, did you just message, did you just send in a, did you just like message people on LinkedIn? Did you send a need? What did you do?
Torbjørn Thomsen: Yeah.
rajalakshmi: yeahp It was basically just growing the network. It was like an amoeba spreading its tentacles across or something like that.
Torbjørn Thomsen: Yeah.
rajalakshmi: So yeah, we reached out to every other person, our mentor and every pathologist on the team will have their own mentors and their guides and people whom they look up to or big figures in the same industry.
rajalakshmi: So we...
Torbjørn Thomsen: Right.
rajalakshmi: reached out to them, tested them, and they're like, okay, let us, you know, try this platform out. And then in the end, they all loved it. But yeah, initially we had to like, yeah, tested them a little.
Torbjørn Thomsen: Right. So you sort of used your existing networks, basically.
rajalakshmi: Yes. Yes.
Torbjørn Thomsen: Right. so this So this started out as ah as a sort of a platform first kind of thing and then grew from there. Is that right?
rajalakshmi: Yeah, but initially we wanted to see how it works because we didn't want to launch it entirely. Even we were a little, you know, cynical. Oh, does it work or, you know, should we go ahead and should we should we focus only as a digital part of it or can we expand it to a workflow?
Torbjørn Thomsen: course.
Torbjørn Thomsen: Mm.
rajalakshmi: So that was our main question.
Torbjørn Thomsen: Mm. Yeah.
rajalakshmi: So when we sent across, we found out that it's way better and way efficient when we tackle the entire workflow rather than just the digital part of it.
Torbjørn Thomsen: Mm.
rajalakshmi: Because there are may there may be many softwares who focus on only the digital part.
Torbjørn Thomsen: Okay.
rajalakshmi: But the thing is, some softwares may focus only on the scanner part of it.
Torbjørn Thomsen: Right.
rajalakshmi: Some softwares may focus only on the, ah you know, just the application based application of that scan part of it. But no one is actually focusing on the workflow, which is actually the main issue here.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So if we tackle the workflow, I feel it will be way better and way faster. Even the labs prefer to simplify workflows. So that was something which is like, you know, that's a huge break. So that was when we thought, okay, yeah, so let's not just stick to a digital pathology platform. Let's make it, you know, broaden and then tackle the entire workflow.
Torbjørn Thomsen: Right, so it kind of it kind of grew into ah more of a... So initially, you kind of thought it was going to be a platform thing, and then it kind of grew into an entire workflow thing?
rajalakshmi: Yes, yes.
Torbjørn Thomsen: Very nice. All right. that Yeah, that makes a lot of sense. So initially, you actually thought it was going to be...
rajalakshmi: it it still has yeah But it still has potential because we can still, it still has potential because we still can grow further.
Torbjørn Thomsen: It still has what? Mm-hmm.
rajalakshmi: Because as more and more pathologists use and as more and more data we get, we can still grow and, you know, increase the AI part of it and increase the pathologist part of it, use this for multiple things and then let's build the future of pathology together.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Yep.
rajalakshmi: So it's like that.
Torbjørn Thomsen: Okay, so um right i don't I don't know if I mentioned this, but my my my show is called it's called Good Build Anyway.
rajalakshmi: Okay.
Torbjørn Thomsen: And the idea behind the the The good is that the struggle in building stuff it is is a good thing. It's not the problem. it's It's actually the good thing. um So what's been sort of the hardest part about doing this for you? And what has that taught you that something easy wouldn't have taught you?
rajalakshmi: One thing was the um the AI part of it was one thing which was really hard to convince pathologists to go into it. And the second thing was that ah the even the ah building even building the platform, there were a lot of issues coming regarding the ah regarding how we would collaborate with other pathologists or how would all this all of this work? Because as a pathologist, I am not very...
rajalakshmi: ah you know, I don't know the entire technology part of it. And the as a even Rahul, for example, he didn't know entirely the pathology part of it. So we had to kind of work together and then see how it works. And then I would tell, you know, what what would be better. And he could tell what would be better.
rajalakshmi: If it works this, this, this, it would be better.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: And then if the triaging works this way, it would be better.
Torbjørn Thomsen: Yeah.
rajalakshmi: And then so we sort of we we had to spend a lot of time discussing and then managing.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: And then there were a lot of trial endeavors as well. uh saying that okay if the uh slides would be uploaded we these we still have certain things to deal with for example we still have the uh we have to look for the credibility of the pathologists we have to look for the credibility of the labs as well the uh the accreditation of the labs as well and then we will have to we have to see how it works and we will still have to figure out certain things and then
Torbjørn Thomsen: Right.
rajalakshmi: So yeah, there's a lot of ah things going on. The workflow part is done, but the rest of it is still a little fuzzy around the edges. So like, yeah, we're trying to sort of straighten it out.
Torbjørn Thomsen: Okay. And have you found a good way to kind of secure the credibility of of people and labs and
rajalakshmi: Yes, right now, one more thing I wanted to tell us right now we're focusing on building the pathology teams across India, Saudi Arabia, Middle East, Asia Pacific and Europe right now.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Okay.
rajalakshmi: So like we want a all the teams to come together and collaborate and to build everything. So right now, our main focus to start with was India.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So the laboratories in India, we, since I come from the system, so I know how the system works.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Okay.
rajalakshmi: So it became it becomes a little easier for us to know what works and what doesn't.
Torbjørn Thomsen: Right.
rajalakshmi: And we know where things fail and where things work.
Torbjørn Thomsen: okay
rajalakshmi: So we know where to add things and if you add a had a step in this particular thing, it work.
Torbjørn Thomsen: right
rajalakshmi: But if you remove the step, it might not work. So we know the ins and outs of the system and that helped a little. And one more thing was that we want, we initially we would like be but would'd like to focus on India and then and in the other regions as well because we have certain networks here in the other regions.
rajalakshmi: So right now, for example, in India,
Torbjørn Thomsen: Okay.
rajalakshmi: ah we know how the labs work. And the in India, there's a certain accreditation system called the ISO 15189. And we have certain other accreditations as well.
rajalakshmi: So each lab will have to maintain a certain standard to get that accreditation.
Torbjørn Thomsen: Okay.
rajalakshmi: And so the labs which tie up with us would have to have that sort of accreditation as well.
Torbjørn Thomsen: Okay.
rajalakshmi: So, yeah, so we are, building on it but the we we we are also ready to take up labs in the rural areas given that they follow a certain criteria that we have because we don't want to compromise on the quality
Torbjørn Thomsen: Right.
rajalakshmi: And we don't want to, you know, we want to deal with good quality control and good quality assurance and provide the best results.
Torbjørn Thomsen: Of course. Yeah.
rajalakshmi: So we don't want to any compromise in that.
Torbjørn Thomsen: Mm.
rajalakshmi: So we will obviously be a little selective towards the labs as well, because that's where the cases come from.
Torbjørn Thomsen: Mm.
Torbjørn Thomsen: Mm.
rajalakshmi: And then accreditation is one of the main things that we have a certain criteria to as well.
Torbjørn Thomsen: Yeah. Okay. Okay. So you have sort of a, yeah, that makes sense. Yeah. So you have sort of an an internal thing and basically you use accreditation. I assume there's some sort of ah public accreditation, though the the ones you were talking about that.
Torbjørn Thomsen: Yeah. Yeah. Okay.
rajalakshmi: Yes, ISO is the there's it's global as well.
Torbjørn Thomsen: Yeah. So yeah.
rajalakshmi: So we can we have we have put a certain standard so that okay, this this particular lab can tie up with us so that they have the standard and then ah yep, and you know, provide better results.
Torbjørn Thomsen: Okay.
Torbjørn Thomsen: All right. So very and so you you you mentioned that you started in India and then you went to other countries. was that What was that in the expansion? what What's kind of deciding where to go next?
rajalakshmi: Um, actually, initially we started in India because all of us, most of us in our team are from India. And so we would obviously love to give to, you know, where we came from, obviously.
Torbjørn Thomsen: Yeah.
Torbjørn Thomsen: Yeah.
rajalakshmi: And then we know the ins and outs of it.
Torbjørn Thomsen: Yeah.
rajalakshmi: So obviously it's better that way it works better. And then slowly we can grow because we have now, Like currently i have moved out. I am in, I'm currently in New Zealand right now.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: And my friend as well, even Rahul Asnik is in the Middle East right now.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So we have a certain kind of networks network, you know, grown here. And then we have certain mentors and
Torbjørn Thomsen: right
rajalakshmi: guides and people to guide us saying that okay this particular platform this particular platform may work here and this particular platform may work here so ah that's kind of how we are moving about right now
Torbjørn Thomsen: Right.
Torbjørn Thomsen: Right. So there's actually, there's a lot of your expansion and testing that's sort of, well, that's based on your network, right?
rajalakshmi: yep but one more thing i want to add is that once the app is
Torbjørn Thomsen: Yeah. Yeah. and that's, I guess that's a
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: um launched, you wouldn't have to worry about any network because anyone across the world anywhere can access it.
Torbjørn Thomsen: Right.
Torbjørn Thomsen: Right.
rajalakshmi: So all you need is a smartphone and an app or a system or a desktop and an app or and the app and you can work from anywhere. You can access it from anywhere.
rajalakshmi: ah Given that you fall into the certain criteria and credibility systems, for example, if you are a researcher, you can You will have to show your credibility somehow.
rajalakshmi: There are some certain things which you have to do. As a pathologist, obviously, if you're reporting slides, obviously, your credibility will be tested and you'll have certain CPDs going on.
Torbjørn Thomsen: Okay.
rajalakshmi: And the labs as well.
Torbjørn Thomsen: Yeah.
rajalakshmi: So we want to make sure that quality is not compromised anywhere and and
Torbjørn Thomsen: Of course.
rajalakshmi: better results, give faster and better results, reliable results to the patient.
Torbjørn Thomsen: Right.
Torbjørn Thomsen: Right. And so you, so initially it was sort of a ah network thing and then it kind of grows organically beyond the network, I guess. Right. Is that what you're, yeah, that, that makes a lot of sense.
rajalakshmi: Yep, yep, yep, yep.
Torbjørn Thomsen: Very, very interesting. um Okay. So I just, I think we're probably getting towards the end here. um I just wanted to,
Torbjørn Thomsen: I had, Well, first of all, where can where can people find out more about you? Where can people find more out more about this? Mm-hmm.
rajalakshmi: ah We have our website right now, which is
rajalakshmi: where you can see what we do and see what the platform gives. And soon we'll be launching our app as well. We don't consider it just as an app launch. And this is like the beginning of a global journey for us So yeah, it's a huge thing.
rajalakshmi: And, and yeah, as I said, real cases, rare cases, and AI assists and the pathologist decide finally.
Torbjørn Thomsen: Yeah.
Torbjørn Thomsen: Do you have a, do you have a plan to kind of do a ah sort of, I guess not right now, but maybe in in time sort of make a ah learning platform part of it as well?
rajalakshmi: Yes, yes, we do. We have a library. already have a library which is which will be accessible soon.
Torbjørn Thomsen: Yeah. Yeah, you must have, yeah.
rajalakshmi: Yep, we have a library of a certain organ systems which are already there.
Torbjørn Thomsen: Uh-huh.
rajalakshmi: And as the system grows, we get the library is ever growing, obviously.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: And the on the platform, you get to have the educational pathology cases. And you can also have the whole slide image viewing.
rajalakshmi: or on your phone or anywhere else and then there is the heat map analysis which is available and the region of interest which can be found out in that and then there are certain snap saved snapshots you can draft reports and stuff and everything as a you can be it uh you can be anyone you can be an educator you can be a researcher you can be a pathologist you can be a resident
Torbjørn Thomsen: you
rajalakshmi: or you can be any lab any part of the lab network. ah You can access the system and then challenge it and then give us feedback and work with it and have fun.
Torbjørn Thomsen: Yeah. Like, and so just some, for my understanding, like how, cause I don't work a lot with microscopes. I i work in orthopedics.
Torbjørn Thomsen: How do you a get the the pictures of the slides themselves from the microscope onto the phone? does How does that work?
rajalakshmi: So what happens is, you know how ah any organ, like when people send their tissues, what happens is the tissues are sectioned, sectioned to a thickness of about 0.4 to 0.6 microns.
Torbjørn Thomsen: Mm-hmm. Mm-hmm.
rajalakshmi: So this tissue is placed on a slide and slide is stained.
Torbjørn Thomsen: Mm-hmm.
Torbjørn Thomsen: Mm-hmm.
rajalakshmi: So what happens after the slide is stained is what that stained slide is what people see under the microscope. So what happens is this stained slide can be placed on a scanner.
Torbjørn Thomsen: Right. Mm-hmm. okay
rajalakshmi: And it's how it's how you know you take a photo of yourself and then you get a soft copy of your photo. It's a similar way.
Torbjørn Thomsen: Right.
rajalakshmi: So here what happens is you scan it. It's like taking a paper and then converting it into a PDF. So it's basically like that.
Torbjørn Thomsen: Okay. All right.
rajalakshmi: So you scan the slide and you get a scanned scanned image here.
Torbjørn Thomsen: Yeah, I can understand that.
rajalakshmi: It's like that.
Torbjørn Thomsen: Yeah.
rajalakshmi: Yeah.
Torbjørn Thomsen: Okay. Very cool. Very cool. All right. Yeah. Because I used to in but when I was in med school, i used to I would take pictures with my phone through the microscope, which
rajalakshmi: Yeah, I know. That's a pain. been there.
Torbjørn Thomsen: didn't work out great, but I mean, it worked out a little bit. Yeah.
Torbjørn Thomsen: Okay. I think, i think, ah I think that's some very interesting things and I wish we could talk more, but i we're getting towards the end here.
rajalakshmi: Yeah, thank you. Thank you, Tori, for you know giving me this platform to talk more about our PatIQ.
Torbjørn Thomsen: Yeah.
rajalakshmi: And then thank you for having me here. It was nice talking to you.
Torbjørn Thomsen: Thank you so much. Thank you so much for coming. I really appreciate it. um I have a ah bit of a ah selfish question here before we end.
rajalakshmi: Thank you.
Torbjørn Thomsen: Who are, do you do you have do you have one or two people you think I should talk to that you would think would be interested in coming on?
rajalakshmi: Go on. Shoot.
rajalakshmi: from the platform is it?
Torbjørn Thomsen: anywhere Anyone you can think of, basically. i always ask this question just I always ask this question just to, apropos networks, right?
rajalakshmi: Yeah, I do have two people.
Torbjørn Thomsen: But I just i just always ask it just to see. Sometimes people have really interesting ideas like, hey, I have this guy that would love to talk about this or you know something like that. Does that make sense?
rajalakshmi: On the top of my head, um this um There are a couple of people actually, but it would be in the same field.
rajalakshmi: But are you okay with that? or
Torbjørn Thomsen: Yeah.
rajalakshmi: I feel like, i feel like um okay, there's one doctor ah from Jayadeva hospitals whom I think you should talk to.
Torbjørn Thomsen: Yeah, then.
rajalakshmi: um
Torbjørn Thomsen: Okay.
rajalakshmi: I can give you more about it in some time.
Torbjørn Thomsen: Yeah.
rajalakshmi: But there's definitely that one person on top of my head who is like, you should talk to, you should not miss talking to him.
Torbjørn Thomsen: Yeah. Would love to.
rajalakshmi: So I feel like, yeah, he's one great potential person.
Torbjørn Thomsen: Perfect.
rajalakshmi: Yeah.
Torbjørn Thomsen: Awesome.
rajalakshmi: It's always a learning curve.
Torbjørn Thomsen: Awesome. All right. Yeah, exactly. Exactly. And there's lots of, there's a lot of interesting stuff to learn.
rajalakshmi: Yeah,
Torbjørn Thomsen: that's part of why I'm doing this is to learn basically. Yeah.
rajalakshmi: yeah it's interesting what you're doing.
Torbjørn Thomsen: Do you, thank you.
rajalakshmi: Nice.
rajalakshmi: ha
Torbjørn Thomsen: do Do you have any, ah any sort of last ditch things you would like to, to get out, like to say?
rajalakshmi: Yes, thing is, um yeah, so the, so PathIQ, you can all you go to the PathIQ platform. It's www.pathiq.in and pathiq.cloud if you want to access anything and then you can go see what we do and then see the team behind it.
rajalakshmi: and you can go access the platform as well, see how it works and stuff like that and we'll soon be launching the mobile app version as well and we're really excited about it and least there's any feedbacks.
Torbjørn Thomsen: Will we be able to...
rajalakshmi: if
Torbjørn Thomsen: Will it be the app? will Will we see on the website when it when it's launched? Where will that be?
rajalakshmi: Yeah, obviously.
Torbjørn Thomsen: Obvious.
rajalakshmi: Obviously, you get to know it on the website as well.
Torbjørn Thomsen: Yeah.
rajalakshmi: And then, yeah, we'll make sure you know
Torbjørn Thomsen: Okay. Very cool.
Torbjørn Thomsen: Very cool.
rajalakshmi: here
Torbjørn Thomsen: Very cool. All right. All right. Thanks a lot, Rich. Okay. All right. Well, ah thanks for coming on. I'm going to just stop the recording now.
rajalakshmi: it. Thank you.
Torbjørn Thomsen: Hold on. Let's...
