American Association for Clinical Chemistry
Better health through laboratory medicine
NACB - Scientific Shorts
NACB - Scientific Shorts (formerly NACB Blog)
By Danyel H. Tacker

​I’ve just emerged from a cave of analyzer & automation selection. We haven’t even had the kick-off meeting, and I’m exhausted (in a good, exhilarated way). This leads me to wonder, “Did I ‘do’ too much? Or did I conduct myself in the spirit of true, due diligence?”

Before I open the floor, I’ll list what my group at WVU did, and things we considered. We:

1. Convened a committee to discuss what we wanted to see, general timetable, who we wanted to include in the initial evaluation, how we’d time the selection, etc. Shortly thereafter, we engaged the “big 5” manufacturers for the initial inquiry.

2. Listed foreseeable change management issues if we’d consider one vendor over the other. One prominent example was the need for an extra or different platform to offset menu gaps on-track, and whether gaps were critical to 24/7 operations or minimally impactful.

3. Listed change management issues that would exist, no matter the vendor chosen. Examples included space for verifying new analyzer performance, scheduling staff for off-site instrument training, staffing for the “manual” phase of the change-over, staff concerns about “losing” automation for this period of time, construction challenges, shifting workstations during different phases of implementation, visions of how to re-assign work for “freed” Full-Time Equivalents/FTEs in the new configuration, etc.

4. Kept in mind: menu (potential sendout-savings and gaps); system scalability & space issues; track-related pros and cons; middleware offerings; and benefits we currently get from automation, which we cannot lose.

5. Highlighted important elements in our local patient mix: broad population, in terms of age, acuity, and service need; solid menus for prominent specialties, in-house and for our outreach efforts; low(er) specimen volume requirements; configurability to automate more assays while achieving our current (manual) in-lab TnI TAT of 22 minutes.

6. Had “demonstration trucks” on-site for tech staff opportunities to provide feedback.

7. Conducted a rough sigma analysis on 45 prominent chemistry & immunoassay analytes, using CAP survey results. We counted world-class, excellent, and acceptable offerings within that group for each vendor. [Poor sigma results were considered “not indicative”, since there are so many influences over result ranges in these surveys, but trends were noted.] We also looked at how the result means varied between platforms, to expose potential future challenges with shifts in resulting (ie, the need to re-baseline tumor marker or cardiac troponin assay results).

8. Called friends/colleagues and asked about their experiences with the various companies.

9. Tracked responsiveness of the vendors with every inquiry we sent out. Every vendor received every inquiry to reduce redundancy on our side.

10. Had 5 workflow analyses performed, and all results presented to both the administrative and technical level staff to enhance Q&A/critical review. We provided the same LIS-derived data set to all 5 vendors for simulating performance of each solution proposed.

11. Surveyed our tech staff after the trucks, educational seminars, and workflow presentations concluded, through anonymous surveys. We asked them to rank the companies generally, and then based on key words (ie, “most reliable,” “best service,” “best track features”).

12. Engaged our residents in the evaluation. They had a fresh, slightly-outside perspective to the process that was very interesting and helpful.

13. Conducted 3 site visits, and timed them with the 8-week Request-For-Proposal/RFP response period. We also requested a silent period during the RFP analysis/review that followed for 6 to 8 weeks. We “pulled” information when clarifications were needed, rather than allowing any “pushing”.

14. Considered cost after all else, and started basic contract negotiations with 2 vendors. We focused comparisons of reagent packaging and concentrations, water consumption, storage needs, reagent slots, throughput estimations, and worst-case TAT effects presented in workflow models between these 2 manufacturers at this time as well (as extra “costs”). After contract basics were ironed out, we made our final decision & finalized the selected contract.

15. Notified other vendors of our selection, and technical staff of how their early feedback aligned with the selection.

As the Chemist, I tried to suspend internal biases, past experiences, and what would be “easiest for me”. I tried to stick to facts and figures. This was incredibly challenging, but essential to learning and discovery.

Activities broke into:
1. Exploration & Engagement – 3 months
2. RFP & Critical Review – 3 months
3. Legal & Financial/Contracts – 2 to 3 months

This leads me full-circle to opening the forum to readers. What was the NUMBER ONE element or activity that you felt was most useful in your last acquisition? If there wasn’t one, but you have a few prominent considerations, please share them with the readership.


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About the Author
Danyel H. Tacker