In nearly every conversation we have with major hospital centers and pathology labs, the question comes up about how to initiate 2nd opinion pathology referrals from outside the US. Everybody wants to know: how can we work with China…or India…or other areas of the world where pathology is dramatically underserved? Most US expert centers have a healthy referral business, with slides arriving via mail and FedEx daily/weekly. Going digital in pathology would provide the means to increase referral business by streamlining and accelerating the process, from image acquisition to diagnostic report.