Sylvia Asa, MD, PhD
Medical Director, Toronto Medical Laboratories
Pathologist-in-Chief, University Health Network
Networking for Success
Digital pathology is a disruptive technology that allows access for any patient to the right Pathologist in a timely fashion. We describe the application of this tool to accomplish a faster, better, cheaper healthcare solution.
To address the need for exponentially increasing knowledge and integration of complex genomic and proteomic data, University Health Network embarked on a program of subspecialty pathology in 2000. This model requires a larger workforce to ensure critical mass in all areas of expertise, and this was accomplished by increasing the number of hospitals participating in the program. Geographic distribution across Ontario provided a model that called for innovation in information acquisition and transfer. We therefore implemented a single anatomical pathology laboratory information system across 21 hospitals. The addition of digital pathology has allowed us to provide on-site intra-operative consultations as required and independent of Pathologist location. Full adoption of digital primary diagnosis is underway.
The application of this technology in a public healthcare system provides a mechanism to rationalize diagnostic medicine yet provide the highest quality of care irrespective of patient location.
Sylvia Asa, MD, PhD is the Medical Director of Toronto Medical Laboratories and Pathologist-in-Chief at the University Health Network. She is a Professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She received her medical and post-doctorate degrees from the University of Toronto and completed her internship in internal medicine at Toronto General Hospital and the University of Toronto. She received her residency training in pathology at Mount Sinai Hospital, St. Michael's Hospital and the Toronto General Hospital, all affiliated with the University of Toronto. She subsequently was a research fellow in the Department of Pathology at St. Michael's Hospital and the University of Toronto.
Dr. Asa has been extremely active in endocrine pathology. She is recognized as an expert diagnostician in this field, and her research has focused on the pathobiology and pathogenesis of endocrine neoplasia. Her research activities have made significant impact in our understanding of pituitary development and tumorigenesis. She has identified pathways of cell differentiation and the transcription factors that regulate this process, as well as aberrant molecular mechanisms of cell proliferation that underlie pituitary tumors. In the field of thyroid cancer, she has implemented translational research to apply novel molecular and immunohistochemical approaches to improve early and accurate diagnosis.
Dr. Asa's work has been recognized by the numerous professional organizations with which she is associated, including The United States-Canadian Academy of Pathology, The Endocrine Society, The Pituitary Society, the Pituitary Pathology Club, and the Endocrine Pathology Society, of which she is a founding member. She has presented more than 250 papers at international meetings and has been an invited lecturer for the National Institutes of Health, the Japan Endocrine Society, the Endocrine Pathology Society and the International Academy of Pathology, among others. Dr. Asa is a founding editor of the journal Endocrine Pathology and has served as an editorial board member for several journals, including the Journal of Clinical Endocrinology and Metabolism, Endocrinology, the American Journal of Surgical Pathology, Advances in Anatomic Pathology, Modern Pathology and Laboratory Investigation. She is a reviewer for 35 major medical journals. Extensively published, Dr. Asa has co-authored more than 300 articles, many in high impact journals. She has authored or co-authored four books and 60 chapters on endocrinology and related pathology, and is the author of the third and fourth series Fascicles on Tumors of the Pituitary Gland in the Atlases of Tumor Pathology published by the Armed Forces Institute of Pathology.
She has been the recipient of numerous awards and honors, including the Arthur Purdy Stout Society of Surgical Pathologists (1998), the Novartis Canada Senior Scientist Award (2001), the Professor C.F.A. Culling Memorial Lecture Award of the National Society for Histotechnology (2004), and several teaching awards from the University of Toronto. She has served as President of the Endocrine Pathology Society (1997 – 1998) and the US-Canadian Academy of Pathology (2005-6).
Her leadership skills have been manifest by her work with many of these external organizations, but it is her work as head of one of the largest pathology departments in Canada, that has made major impact on the future of pathology. In the last six years, she has accomplished the consolidation of three large departments from three hospitals under the auspices of the University Health network. Dr. Asa has made innovative changes to the practice of the discipline, with an emphasis on automation, electronic initiatives, and telepathology. The department takes a highly sub-specialized approach to diagnostic activities, education, and research in cytopathology, surgical and autopsy pathology. The understanding of mechanisms of disease and translation to diagnostic and prognostic information for patient care requires integration of conventional histology with immunohistochemistry, electron microscopy, flow cytometry, cytogenetics and molecular diagnostics, all of which are utilized for advanced diagnostic approaches. Her department also embodies strong primary research programs and collaborative clinical research based on tissue procurement with pathologist interpretation.