Empowering pathologists to diagnose with speed and confidence.
I designed and shipped a new collaboration tool called Region Comments on our Patient Diagnostics platform which significantly reduced diagnosis turnaround times, leading to a noticeable increase of XX% in the number of cases signed out daily by pathologists.
My Role
Product Designer — User Research, Stakeholder Alignment, Interaction Design, Rapid Prototyping, User Testing, Handoff
Team
Sandy Zhu, Design Manager, Riley Hunter, Design Researcher, Jamie Harisiades, Product Manager, 5x SWE's
Company
PathAI
Timeline
2 Months
Problem
Pathologists lack a fast, reliable way to get second opinions.
Pathologists currently lack an efficient, reliable way to collaborate when they need a second opinion, especially on complex cases. Cases like these still rely heavily on expert judgment to ensure accuracy, but without a dedicated workflow for collaboration, they are forced to rely on slow workarounds. Today, the most common method is sending screenshots over email or sharing accession numbers, a manual, disconnected process that delays critical decisions and increases the risk of miscommunication.
In high-stakes cases (e.g. possible cancer), delays in diagnosis can directly affect patient outcomes, making speed and accuracy critical.
Such delays can put patient lives at risk.
Research
Understanding how pathologists seek second opinions today.
To understand how pathologists collaborate today, I began with organizational research and aligned with my PM on the problem scope. We decided to focus on informal (curbside) consultations, since they are the most frequent and high-friction part of the workflow.
To learn how these consultations happen in the real world and how we might bring them into the platform, I partnered with a senior design researcher to create a decision guide and conducted five semi-structured interviews with pathologists. I captured key observations and workflow insights in Airtable so they could scale across teams and inform future design decisions.
Link to discussion guide used for user research interviews.
As patterns began to emerge from the interviews, it became clear that collaboration is a fundamental part of a pathologist’s workflow, much like how we as designers seek feedback on our work. As I dug deeper, I was able to identify a few key insights in collaboration that directly informed design requirements for the solution.
Explorations
Turning workflow insights into design direction.
I began with interaction and visual exploration, gathering UI references for fast decision-making—quick actions, canned messaging, and inline commenting. This workflow research informed my initial design explorations and prototypes.
I explored with multiple card layouts, experimenting based on metadata such as author, slide numver, timestamps, and titles). These explorations helped define what information needed to be prioritized to help pathologists quickly identify relevant comments.
It took nearly 20 design iterations to make the comment card truly contextual and intuitive for pathologists.
Iterations
Design evolution shaped by testing, insights, and trade-offs.
My early explorations used a central pop-up modal next to the marked region to create a focused typing experience. However, iterative usability testing revealed a key issue; pathologists needed to see the surrounding tissue while writing a comment to maintain diagnostic context.
Based on this feedback, I moved the commenting experience into the left slide panel. This not only preserved visual context but also made it easier to associate each comment with its specific slide.
Iterated from modal pop-ups to inline slide annotations based on usability testing.
I first proposed threaded comments to enable structured discussions and placed them in the Accession Discussion panel, based on quick consult behavior. But in review, my PM challenged the narrow focus on just consults and asked me to explore broader use cases. After speaking with pathologists again, I learned they also needed this for teaching, tumor boards, QA, and research.
Based on that feedback, we moved the feature into the slide panel and redesigned it as Region Comments so each note could stay connected to a specific slide area. This made it more useful for both collaboration and personal workflows.
Pivoted from a chat-style consultation tool to a slide-specific annotation tool.
One of the key tradeoffs during handoff was deprioritizing email integration and @mentions. Both features depended on another team’s codebase and weren’t feasible within our release timeline. To keep momentum, we shipped a simpler manual link-sharing workflow for v1 and scheduled the advanced collaboration features for version 1.1. This allowed us to deliver value quickly and get the feature into users’ hands without delaying the release timeline.
Design trade-offs; deferred @mentions and email integration to v1.1
Solution
Region Comments: fast, traceable, & contextual collaboration at slide level.
Region Comments allows pathologists to draw a region on a slide, leave a contextual note, and start a focused discussion without leaving the viewer. Each comment stays anchored to the exact area of interest, and threaded replies make it easy to clarify findings or request a second opinion.
Proposed solution workflow: creating and receiving region-based comments.
For the pathologist asking a question, Region Comments makes consultation faster by letting them mark a region on the slide and add context directly—no screenshots, no long explanations, no switching tools.
Creation workflow
For the pathologist receiving the request, the comment opens at the exact region of interest, making it easy to review, reply, and resolve discussions without losing diagnostic context.
Receiving workflow
During handoff, I documented detailed design specifications for engineering, including user flows, interaction behaviours, region magnification rules, and edge cases across single and multi-slide accessions—such as bounding while typing, comment limits, and handling incomplete comments when a user exits mid-action.
Edge-cases; region interaction states
Card component spec sheet
Impact
Faster case sign-outs with higher diagnostic precision.
After launching Region Comments in Q4 2022 with our beta users, we saw a clear improvement in diagnostic workflows. Pathologists were able to resolve questions faster, reducing delays caused by email-based collaboration and helping increase daily case sign-outs. The feature also improved diagnostic confidence by keeping feedback tied to precise slide regions, reducing miscommunication and preserving clinical context.
Beyond consultations, teams began using it for quality review, peer learning, and tumor board preparation, showing strong adoption and meaningful value across real pathology workflows.
Reflections
What I learned designing in a complex, specialized domain.
In retrospect, my summer at PathAI was both challenging and fulfilling, preparing me for the "real world". My manager and mentor gave me the nudges I needed to continue moving forward while also giving me the autonomy to do my own research, iterations, prototyping, and design feature presentation. Here are some highlights:
Be people proactive - Wherever you go, you'll find people eager to share knowledge, give feedback, and connect. Some of my most memorable moments at PathAI came from one-on-one interactions. Seek feedback, ask questions, and stay curious—it’s a great way to grow.
Embrace ambiguity - The most challenging project I worked on pushed me to adapt to constant changes in a fast-paced environment. It taught me how to thrive amidst uncertainty, honing my ability to navigate shifting demands.
Managing expectations - Set realistic expectations to avoid unnecessary stress and misalignment. I once overcommitted despite being stretched too thin, resulting in subpar work. It’s okay to push back when needed—clear communication and regular updates are key to staying aligned.
More work, more stories.
