Clinical Chemistry 46: 764-771, 2000;
(Clinical Chemistry. 2000;46:764-771.)
© 2000 American Association for Clinical Chemistry, Inc.
Laboratory Automation: Trajectory, Technology, and Tactics
Rodney S. Markin1,a and
Scott A. Whalen2
1
University of Nebraska Medical Center, Department of Pathology and Microbiology, 983135 Nebraska Medical Center, Omaha, NE 68198-3135.
2
Aultman Hospital, 2600 Sixth St. SW, Canton, OH 44710.
a Author for correspondence. Fax 402-559-6018; e-mail rmarkin{at}unmc.edu
Laboratory automation is in its infancy, following a path parallel to
the development of laboratory information systems in the late 1970s and
early 1980s. Changes on the horizon in healthcare and clinical
laboratory service that affect the delivery of laboratory results
include the increasing age of the population in North America, the
implementation of the Balanced Budget Act (1997), and the creation of
disease management companies. Major technology drivers include outcomes
optimization and phenotypically targeted drugs. Constant cost pressures
in the clinical laboratory have forced diagnostic manufacturers into
less than optimal profitability states. Laboratory automation can be a
tool for the improvement of laboratory services and may decrease costs.
The key to improvement of laboratory services is implementation of the
correct automation technology. The design of this technology should be
driven by required functionality. Automation design issues should be
centered on the understanding of the laboratory and its relationship to
healthcare delivery and the business and operational processes in the
clinical laboratory. Automation design philosophy has evolved from a
hardware-based approach to a software-based approach. Process control
software to support repeat testing, reflex testing, and transportation
management, and overall computer-integrated manufacturing approaches to
laboratory automation implementation are rapidly expanding areas. It is
clear that hardware and software are functionally interdependent and
that the interface between the laboratory automation system and the
laboratory information system is a key component. The
cost-effectiveness of automation solutions suggested by vendors,
however, has been difficult to evaluate because the number of
automation installations are few and the precision with which
operational data have been collected to determine payback is
suboptimal. The trend in automation has moved from total laboratory
automation to a modular approach, from a hardware-driven system to
process control, from a one-of-a-kind novelty toward a standardized
product, and from an in vitro diagnostics novelty to a marketing tool.
Multiple vendors are present in the marketplace, many of whom are in
vitro diagnostics manufacturers providing an automation solution
coupled with their instruments, whereas others are focused automation
companies. Automation technology continues to advance, acceptance
continues to climb, and payback and cost justification methods are
developing.
Copyright © 2000 by the American Association for Clinical Chemistry.
