Clinical laboratory medicine is undergoing dramatic change driven by rapid technological advances, the increased testing needs of an aging population, a chronic personnel shortage, an expanding role on the healthcare team, and most recently, the Covid pandemic. Reference laboratories are responding with expanded test menus, reduced turnaround times and longer operating hours, all the while determined to provide quality patient care in a cost-effective manner.
This increased demand for higher levels of service means that the need for automation has become ever more essential. This has long been regarded as an important strategy for laboratories to achieve greater operational efficiency, improved test accuracy, method standardization, total data handling and reduced turnaround time.
Until recently, the expense and complexity of installing an integrated laboratory automation solution has been a deterrent to implementing automated systems of any kind. However, current generations of automated equipment do not require the commitment to total laboratory automation, and may include modules designed to automate only a portion of a laboratory’s operations. Modular automation allows recombination of modules as the needs of the laboratory changei.
Automation Improves Laboratory Productivity
For laboratories, efficiency equates to reducing the number of process steps. Automation tailored to the needs of the laboratory can expedite workflow and optimize the use of personnel and equipment, improve safety by reducing contact with potential biohazards, and allow staff to spend more time verifying abnormal or critical results.
Automation can improve productivity in the following ways:
Decreased Turnaround Time(TAT)ii
When appropriately configured, a laboratory automation system streamlines and shortens TAT and TAT variability, even during peak workflows. Interfacing analyzers with a Laboratory Information Management System (LIMS) automates the complete analytical and post analytical processes of a laboratory and facilitates auto-generation and auto-dispatch of reports to patients.
Reduced Manual Specimen Handling
Staff touch a specimen tube once, and the system handles it the rest of the way. Installing an automated specimen transport system between the pre-analytic, analytic, and post-analytic phases of testing can markedly improve efficiency and reduce manual steps by as much as 80%.
Efficient Specimen Storage and Retrievaliii
There are different levels of automation that can minimize or eliminate manual steps for specimen storage and retrieval and provide quick access to the sample and immediate transport to the instruments for testing. Semi-automated systems archive samples in trays that are manually transported to the refrigerator. Fully automated systems take this a step further, with automated delivery to the storage unit and automated retrieval once a subsequent test is ordered.
Provide Quick Data Accessibility
Automation enables the tracking of every activity performed in the laboratory, automatically generating digital data using the LIMS. With detailed reports accessible at the click of a button, it is easier to analyze and draw insights from it to make informed decisions.
Automate Quality Control Checks
Routine quality control for instrument testing is based on manufacturer’s recommendations, usually every eight hours. This has proven to provide reliable testing quality, with the caveat that any unexpected trends in patient test results noted are cause for further investigation.
However, with automated quality control, patient results are monitored continually to determine if they are trending toward normal or extended ranges, so that testing staff can be alerted immediately of a possible performance issue. This might indicate QC problems, invalidating the test run. This enables lab staff to take immediate corrective action, preventing the need to rerun patient testing lateriv.
Steps for Achieving the Right Automation for your Laboratoryv
A. Consider the level of automation needed for your laboratory
What are the number and types of specialties tested? What is the extent of automation already present? Are you an independent laboratory, or part of a larger office or medical complex?
If your primary goal is increased throughput of tasks that are repetitive and monotonous, and thus prone to human error, and you do not have to deal with diverse assays and readouts, then you might consider Task Targeted Automation (TTA). This approach utilizes nonintegrated pieces of equipment, enabling the throughput needed without requiring a huge investment, or additional space.
The other option is Total Laboratory Automation (TLA) systems that use conveyors to link specimen-processing functions to analyzers and often include post-analytical features.
B. Set priorities for automation based on realistic budget limitations
Think about automation beyond your current application and build an infrastructure that can be easily modified or expanded for other applications at a later date. The present trend is to buy smaller integrated systems that are more flexible and allows labs to accommodate more options for testing, and faster throughput.
Large, centralized laboratories may still rely on big integrated systems, but for others, the flexibility to adapt to different assays is becoming more importantvi.
C. Plan for downtime for routine maintenance and equipment breakdown
With time and experience, you can estimate how much “buffer” time you need to build in for preventive maintenance and downtime. Having an infrastructure to minimize downtime is critical.
The Future of Laboratory Automation….
This will continue to be driven by the need to do more with less, as laboratory budgets are reduced and staffing shortages increase. In order to better allocate skilled resources in the lab, newer automation systems will be able to more efficiently handle the tedious, and sometimes hazardous, tasks while skilled laboratory professionals are able to focus on important matters that require human interaction.
i G Tufel. Right-Sizing Laboratory Automation. Clinical Lab Products. December 17, 2014. http://www.clpmag.com/2014/12/right-sizing-laboratory-automation/
ii Covill, L. The LEAN Lab: Automation, Workflow and Efficiency. February 19, 2015. Medical Laboratory Observer. https://www.mlo-online.com/continuing-education/article/13008087/the-lean-lab-automation-workflow-and-efficiency
iv Nadeau, K. Artificial intelligence pushes lab automation forward. December 22, 2021. Medical Laboratory Observer. https://www.mlo-online.com/information-technology/artificial-intelligence/article/21250827/artificial-intelligence-pushes-lab-automation-forward
v M. Ferrer. Ask the Expert: How to Automate Your Lab to Best Fit Your Needs. Lab Manager. January 2011. http://www.labmanager.com/ask-the-expert/2011/01/ask-the-expert-how-to-automate-your-lab-to-best-fit-your-needs
vi MLO staff. Achieving a Lean lab Through Automation. July 1, 2011. Medical Laboratory Observer. https://www.mlo-online.com/home/article/13004067/achieving-a-lean-lab-through-automation