Image of the DxA 5000 courtesy of Beckman Coulter
Today’s clinical labs are experiencing a shortage of personnel, but the labs themselves can’t slow down.
“Value-based healthcare puts a premium on delivering patient outcomes,” Timea Zsiray, director of strategy and marketing for Beckman Coulter’s Workflow and Informational Technology Solutions Business, explained during a press conference at AACC 2019. Clinical labs are an essential part of healthcare, as “65 to 70% of [healthcare] decisions are made based on lab data,” she explained.
Consequently, “labs have to improve turnaround time while delivering accurate results,” she added.
Automation is a promising solution. She pointed out that “32 main steps are typically performed in the lab, most of which are performed manually,” and added that manual processes are "time consuming and error prone. There is "a need to make lab personnel’s jobs easier.”
However, “automation is not just the movement of tubes—but also the digital movement of data,” Zsiray.
Healthcare professionals who spoke during the press conference all agreed that healthcare systems are experiencing a shortage of well-trained medical professionals. These speakers included Dr. David Koch, associate professor of pathology at Emory University School of Medicine and director of clinical chemistry, special chemistry, toxicology and point-of-care testing at Grady Memorial Hospital in Atlanta; Dr. Steven H. Wong, professor of pathology and director of the clinical chemistry and toxicology core laboratory, and co-director of the clinical and translational mass spectrometry center at Wake Forest School of Medicine; and Robin Ades, senior regional director of operations for Alverno Laboratories.
Said Koch: “We don’t have enough people going into the clinical lab profession.”
Added Ades: “Small- and mid-sized labs have the same staffing issues, especially in rural areas where we don’t have the pool of applicants as in the past.” And efficiency is expected of all labs, regardless the size. “Turnaround time expectations are the same despite the size of the healthcare system,” she added.
These professionals are hopeful that automation can help fill the gap. “Automation makes it possible to deliver high throughput,” Wong said.
“Automation has been critical to our success at Grady Hospital in Atlanta,” said Koch, adding later that “automation helps all staff, even part-time and weekend staff. They have to produce the same high-quality result as the Monday-Friday staff.”
Automation may also enable labs to maintain staff engagement. “We’ve found that we needed our techs doing clinical scientific lab work, not mundane tasks such as specimen processing and loading them into instruments,” said Ades. Koch agreed: “Graduates want to be involved in meaningful work. Getting the result to the doctor that will benefit the patient is the most important, rather than fussing over minutia that could be handled by automation.”
“If staff is satisfied and happy, they are more likely to stay,” said Wong.
However, today’s emerging automation solutions mean more than just moving samples around in a lab. Automation can also contribute to efficiency in processing and results delivery. Automated IT allows labs "to be more fail safe in terms of labeling and specimen errors,” said Ades. Added Koch: “We can rely on IT to auto-validate much of the data.”
To support such automation needs, Beckman Coulter’s newest solution automates sample handling and more. At AACC Beckman Coulter highlighted WorkflowConnect, WorkflowAdvanced, and WorkflowCommand solutions that are designed to meet the needs of small-, mid-, and high-volume laboratories. It also demonstrated its newest total laboratory automation solution, the DxA 5000, which is intended to improve efficiency through several onboard funtions that help identify and address pre-analytical errors, automate labor-intensive and error-prone laboratory tasks, and auto-verify and release normal results.
The DxA 5000 combines sample-processing hardware with informatics from WorkflowConnect, WorkflowAdvanced, and WorkflowCommand middleware. Tubes are bar coded and after being loaded into the system move through centrifugation and other processes. Data is captured on the status of each sample as it moves through processing, and results are captured and transmitted as soon as available.
“Automation used to be moving a tube from A to B,” explained Dr. Christoph Moellers, vice president and general manager of Beckman Coulter’s Workflow and Informational Technology Solutions Business. “Now, we receive a tube and deliver a result—everything in between is automated. We used to focus on ‘push’ mechanisms—a tube comes in and we push it down the line. Now we use a ‘pull’ mechanism—we pull requests to analyzers to maximize operational throughput.
"We didn’t have the software in place before to perform that ‘pull,’ " he added. Now, "we have that connection in the middleware.”
Ades appreciates such capability. “It’s the scalability of the data flow,” she said. “The middleware piece is important for us to be standardized across our systems.”
In addition, the automated system features a “minimum amount of failure points in the system to maintain uptime,” Moellers said. He said that Beckman Coulter had interviewed 180 customers globally and found that labs are challenged to maintain short turnaround time with consistent results.
Beckman Coulter’s solutions are also intended to meet the needs of labs of varying size. “We believe in automation for all, so we designed the system to be modular, so we can scale it,” he said. “Mid-sized hospitals don’t always have the buying power or the space in terms of footprint.”
Beckman Coulter’s focus on data could also help it meet the needs of both centralized and decentralized laboratories. “I am sure whatever direction [trends go], you need a tool to connect the dots and the data. That’s why informatics is so critical,” Moellers said.
Added Koch: “The key is that the lab houses the data and provides the data to the clinician. Automated solutions help small and large labs and all those in between.”
Wong believes that automation could support emerging diagnostics testing such as multiple-panel biomarker testing, personalized medicine, and genomics and “enhance the delivery of that information.”