For U.S. Healthcare, Time Is Right for Laboratory Automation

 As the United States begins to address the impact of healthcare reform, global health systems are facing unprecedented challenges, including the economic burdens associated with rising costs, chronic diseases, and caring for aging populations. As a result, there is growing demand for greater quality and efficiency in the delivery of patient-care services. Laboratories worldwide are facing similar challenges, fueled by greater demand for diagnostic testing, shortages of trained technologists, new quality mandates for health providers, and changing reimbursement policies. The key challenge for medical testing laboratories of all sizes and their suppliers is to find innovative and cost-effective ways to improve testing efficiency, eliminate errors, conserve labor, and relieve workload pressures.

Demand for Diagnostic Tests Rising Steeply

The aging of America is spurring record demand for healthcare services, including laboratory testing. Today, 70 percent of diagnostic decisions are made on the basis of laboratory test results.[1] For most laboratories, the medical testing business is very good, but soaring demand is precipitating a serious workflow and productivity crisis because there are not enough qualified technicians and technologists available throughout the United States. Key factors contributing to the problem are retirements and closings of laboratory technician training programs.

According to a 2011 study published by the American Society for Clinical Pathology (ASCP), 43 percent of clinical laboratories surveyed said it is difficult to find personnel. It will take years, perhaps decades, to solve the lab staffing shortage problem. But laboratories and their suppliers must take immediate measures to address increasing demand for diagnostic tests, and lab managers can ill afford to continue investing precious staff time on laborious manual steps and procedures. Testing workloads could become unmanageable for many laboratories, with serious implications for public health. Understaffed and overstressed labs are prone to make mistakes with devastating medical and financial consequences.  

Lab Automation Ensures Consistent Quality

For years, manufacturers of diagnostic testing equipment have been promoting the benefits of stand-alone and total laboratory automation sample-management systems. They based their marketing on demonstrating how these products save time, reduce manual steps and technician labor and, above all, remove the human element from sample management to lower the risk for mistakes. The revolution in U.S. healthcare has made laboratory automation more attractive and compelling than ever. For hospitals today, providing consistent quality is paramount in all aspects of clinical care—nursing, pharmacy, and laboratory testing, to name a few. Health insurance companies are insisting that providers deliver consistent, high-quality care without costly medical errors that can lead to repeat procedures and increase lengths of hospital stays. For the laboratory, rapid turnaround time and increased throughput are still important but not at the expense of consistency in quality.

The emergence of accountable care organizations on the U.S. landscape is shifting the focus of healthcare to quality assurance. Accountable care organizations are formed by groups of physicians, hospitals, and other providers to offer coordinated, top-quality care for Medicare patients. (Note, there are commercial ACOs driven by plans for all patients, not just Medicare.) The goal for ACOs is to ensure that patients, especially those with chronic diseases, receive timely, appropriate, and error-free care without unnecessary procedures or duplicate services. Laboratories serving institutions within ACOs are expected to do more with less while providing accurate test results. The payoff comes when ACOs succeed in delivering high-quality and cost-effective patient care, and share in the savings realized by Medicare. The financial incentives for laboratory automation have never been stronger.

One way in which labs can play an essential role within ACOs and promote improved healthcare quality management is by allocating resources to implement state-of-the-art laboratory automation using new-generation automation systems that tie together multiple analyzers, pre-analytical and postanalytical automation devices, and software. Labs employing advanced automation capabilities can expand capacity to process greater volumes of tests and improve turnaround times, while reducing errors, enhancing productivity, and lowering costs. Getting accurate test results back faster influences how well patient care is delivered by speeding diagnosis and the subsequent appropriate treatment.

As laboratories face challenges from staffing shortages, budget constraints, and increased testing demands, advances in automation technology can help them be more productive and achieve more than 40 percent greater efficiency. (2) By automating pre-analytical and postanalytical steps, sample handling, and processing, laboratories can reduce errors and improve workflow. Simply put, the more manual steps involved in lab testing, the greater likelihood for errors. Automating sample management tasks, such as decapping and recapping test tubes, aliquoting, storing and retrieving specimens, and transferring patient identification labels, can reduce errors while freeing the time of overworked lab personnel for other tasks.

Lab automation systems with a modular design offer the ability to install multiple combined analyzers and modules on a single system, allowing labs to address their testing needs today while planning for the future. Modular systems can consolidate multiple analytical instruments into a unified workstation by employing a common sample processing capability. Through communication connections among the automation system, analyzers, and laboratory information system and middleware, the automation software provides workload and sample-order management, as well as instrument operational status monitoring.

Lab Automation Can Drive New Business

In most cases, laboratories that use automation are able to increase their testing volumes, and this often creates opportunities to expand client outreach by attracting new testing business from physician groups and local companies outside the defined service area. By leveraging the productivity and workflow benefits of laboratory automation, a health system can significantly expand its testing business outreach. Laboratory automation not only helps to improve quality and saves time and labor, it also helps increase the top and bottom lines.

Success for healthcare providers in today’s environment requires confronting challenges posed by healthcare reforms and the mandate to do more with less while satisfying ever increasing demands for testing services at lower cost. Sound impossible? Maybe. However, for laboratories, automation has become a prized resource for delivering high-quality testing, assuring these challenges are met, and always giving the right patient the right result at the right time.

David Overcash is senior product manager, global marketing, automation, at Abbott Diagnostics (Abbott Park, IL). He can be reached at [email protected].

References

1. “Diagnostics and Policy: Innovation and Value,” AdvaMedDx; advameddx.org/go.cfm?do=Page.View&pid=8.

2. D Rajkovich, W Mercer, “The Impact of Automation on Laboratory Operations,” Chi Solutions (Ann Arbor, MI, July 2009).