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Inside Sørlandet Hospital’s transition to fully digital pathology

Fully digital pathology at Sørlandet Hospital, Kristiansand

The Pathology Department at Sørlandet Hospital, Kristiansand in Norway is a true example of how digital transformation can make workflows faster and more efficient.

It is part of Helse Sør-Øst RHF (South-Eastern Norway Regional Health Authority), the largest of Norway’s four health regions. Kristiansand plays a leading role in the region’s digital pathology rollout. The goal is to let pathologists across eight hospitals share expertise, balance workloads, and deliver faster, high-quality diagnostics for patients.

From three scanners to a fully digital workflow

The department’s digital journey began in September 2023 with the installation of two Hamamatsu Photonics’ NanoZoomer^®S20MD scanners and one NanoZoomer S60v2MD. The compact S20MD units are ultra-fast and can run in parallel, making them ideal for scaling up throughput as slide volumes increase. The S60v2MD adds flexibility with the ability to scan both standard and double-sized glass slides used for larger tissue samples.

The mix of S20MD and S60v2MD models works seamlessly together, producing consistent image quality and color tones. This uniformity is achieved through the shared high-quality optical elements and color-correction method used across Hamamatsu’s IVDR-compliant portfolio. In daily use, the scanners function as one connected system, giving the team flexibility in workload distribution and confidence through system redundancy.

NanoZoomer S20MD Slide scanner system C16300-21MDEU

NanoZoomer S60v2MD Slide scanner system C16600-21MDEU

After validating and optimizing the first installations, the team scaled up their digital setup. The initial units helped fine-tune the workflow, and once the configuration proved stable, the hospital expanded. In February 2025, the department added two more S20MD scanners and another S60v2MD, completing the full digital configuration that is in use today. The new setup went fully live in March 2025, marking the hospital’s official transition to 100 % digital histology diagnostics. Cytology followed with a full digital transition in August 2025.

DICOM images are sent directly from the scanners to the hospital’s PACS, which is integrated with the hospital LIMS. This means each case can be accessed together with its corresponding images. In the scanner room, a dedicated workstation allows laboratory staff to perform quality control immediately after scanning, while pathologists review and diagnose cases from their own PACS workstations. This ensures a seamless flow from slide preparation to final reporting.

Compact, smart, and efficient

The digital scanning room in Kristiansand is small but very well organized.

Two pairs of NanoZoomer S20MD scanners are neatly stacked to save space, and two S60v2MD scanners stand beside them.

Nine wall-mounted monitors show the status of all scanners and workstations, giving the team a clear overview of the entire workflow.

In this compact space, efficiency is key. During a throughput test with the four S20MD scanners, slides were continuously loaded throughout the day. In just 7.4 hours, the team scanned 1,577 slides averaging about 210 slides per hour in total, or around 53 slides per scanner. These were full-size diagnostic samples, not the small 15 mm × 15mm test slides often used in technical brochures. This makes the result a true reflection of the department’s daily efficiency.

Thanks to the well-coordinated setup, scanning runs continuously and reliably, with no bottlenecks and plenty of room to expand in the future.

A technical assistant working in scanner room

“We’re 100 % digital now, but we’re not done yet.

The next step is to make the workflow more practical and logical — everything should be arranged so we don’t waste time walking back and forth between steps.”

“The exciting part is what comes next: automation that takes care of the repetitive jobs and gives people better, more ergonomic tasks.”

Kim-Andreas Ulstad, Histology Department Manager at Sørlandet Hospital

Looking ahead

The digital transformation in Kristiansand is still evolving. With the fully digital workflow now established, the team is beginning to explore what the next steps could look like. Automation and artificial intelligence are both areas they would like to move towards in the future, especially to reduce repetitive tasks and support pathologists with growing case volumes.

These ideas are still in the early planning stage, but the team is enthusiastic about the possibilities and is looking forward to what the next years may bring. As one of the pathologists explained: “AI will help us work faster and smarter, but the final decision will always remain ours.” Kim-Andreas Ulstad

The team views digital pathology not as a finished project but as a continuous journey toward better collaboration, smarter workflows, and ultimately, improved patient care.

A strong foundation for the future

The Pathology Department at Sørlandet Hospital in Kristiansand shows how thoughtful planning, teamwork, and the right technology can transform a lab. Their combination of Hamamatsu NanoZoomer scanners and a fully integrated PACS platform has created a reliable, high-throughput digital workflow that supports faster, high-quality diagnostics. With a strong digital foundation in place, the department is well positioned to build on this success whether through automation, AI, or further regional collaboration. Sørlandet Hospital is setting a benchmark for the entire Helse Sør-Øst region and beyond.

Technology partners

This digital transformation was supported by close collaboration with experienced technology partners. Inter Instrument and Visiopharm have collaborated for over 15 years, building a strong foundation for advancing digital pathology in Norway. This enduring partnership combines Inter Instrument’s local market expertise with Visiopharm’s world-leading image analysis and AI solutions. Together, they aim to drive scanner sales while shaping the future of pathology through innovative AI-powered applications, enabling laboratories and hospitals to achieve greater diagnostic accuracy, efficiency, and scalability.

Profile

Kim-Andreas Ulstad is Histology Department Manager at Sørlandet Hospital. He has been with the department since 2018 and has worked in pathology since 2011. He served as Implementation Manager for digital pathology in the department and as Regional Laboratory Coordinator for all eight pathology departments during the regional digital pathology project.

About the author

Marta Bohle, PhD

Marta Böhle, PhD, is an Application Engineer at Hamamatsu, specializing in both research and clinical whole slide imaging using NanoZoomer scanners. With a PhD in Neuroscience and extensive experience in diverse imaging techniques, Marta is passionate about imaging and dedicated to supporting customers in their projects.

As of March 2026, cytology is not within the intended use of NanoZoomer products.

The NanoZoomer line-up and medical device regulatory status varies across countries. For more information, please contact your local Hamamatsu sales representative.