Automation Tim James Head BMS, Clinical Biochemistry, Oxford University Hospitals NHS Trust Visiting Professor, Oxford Brookes University Overview • His tor ica l dev elo pment • Gen er al chemis try co mpo nents • Automated immunoassay • Standalone automa tio n • Link ing anal ytica l s ystems t hrou gh tracking • Pr ocurement
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8/12/2019 20130618 TJames Principles of Automation
• Needs more breadth of confidence with all automationelements ie chemistry analyser, immunoassay analyser,track, centrifuge…
• Need access to good quality metrics and data on usage
• Need on-going improvements in specimen receptionprocesses
• Post-analytical phase – utilise all the functionality availableon Data Management systems to minimise staff time usedfor data review – reflex testing, QC rules, re-run ability,automated comment addition
8/12/2019 20130618 TJames Principles of Automation
• Access to good metrics essential to assess theimpact of investment
• Pre and post analytical re-engineering and on-goingrefinements are critical
• Supplier can give advice on getting the best from
automation systems
Summary• Clinical biochemistry laboratories have benefited significantly from developments in
automation, instrumentation and robotics.
• Two main types of instrument, the general chemistry analyser and the immunochemistryanalyser predominate but a wide range of hybrid and combination analysers are available
• A thorough understanding of the individual analyser components and their relativemechanical and data interactions enables operators to troubleshoot problems moreeffectively
• Consolidation of most of the biochemistry repertoire is now possible on a single system that
comprises a set of integrated analysers.
• Automation of the three phases of laboratory testing, namely pre-analytical, analytical andpost analytical in a continuous process.
• A complex automation system requires monitoring and management to achieve consistentand optimal efficiency.
• On-going maintenance and standard regimes of operation need defining and completion foroptimal operation of automation
• Automation has resulted in significant reduction in manual intervention in the total analyticalprocess.
• Automation produces shorter and more consistent test turnaround times
• For maximum utilisation of automation total laboratory processes need to be reviewedregularly
8/12/2019 20130618 TJames Principles of Automation
• Plan ahead – 2 years prior to procurement initiation. Get your factstogether – visit sites and talk to colleagues at other centres.
• Define high level scope – particularly which disciplines will be involved
– get buy in from the wider team – haematology, coagulation, virology,estates, IT, procurement, finance.
• New procurements facilitate common processes and gains in efficiency
• Develop fine level detail of an output based specification – mainlywhich tests.
• Ask your lab leads for the copy of the last technical specification – compare this to what you have in the lab
• EU procurement process is well defined – know what it is!
• Risk of challenge high as value and length of contracts has increased
References
Buckley-Sharp MD et al. Introduction of a Vickers M300 analyser into the routine service of ahospital laboratory: Installation, staffing, logistics. J Clin Path. 1976, 29, 322-327
Westgard JO et al. Performance studies on the Technicon "SMAC" analyzer: Precision andcomparison of values with methods in routine laboratory service. Clin Chem.1976 ;22:489-96.
Little AJ et al. Comparative evaluation of a Technicon SMAC2/RA1000 System with an
American Monitor Parallel during normal service work. Journal of Clinical Laboratory Automation1986;8: 207-210Roberts WL. Chapter 5: Principles of Clinical Chemistry Automation.In: Michael L. Bishop, Edward P. Fody, Larry E. Schoeff. Clinical chemistry: principles,procedures, correlations. 5th edition, Lippincott Williams & Wilkins, 2004.
Melanson SEF, Lindeman NI, Jarolim P. Selecting automation for the Clinical ChemistryLaboratory. Archives of Pathology and Laboratory Medicine. 2007; 131: 1063-1069.
The Immunoassay handbook. Editor: Wild D. 3rd Edition 2005. Elsevier Science.
Wheeler M. Overview of robotics in the laboratory. Annals of Clinical Biochemistry. 2007; 44:209-218.
James T. Chapter 2: Automation. In: Clinical Biochemistry. Ed Ahmed N. 2010. OxfordUniversity Press Oxford, UK. ISBN 13: 9780199533930