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If mankind's strongest fear is, as H.P. Lovecraft once wrote, "that of the unknown," then it is clear why many clinical laboratories continue to drag their feet when it comes to implementing automation. Taking that first step into the unfamiliar realm of automation can be a daunting task for any facility. Labs no doubt become comfortable with a process that has been cemented by years of routine, and the thought of disrupting that process in any way based merely on a promise of greater efficiency can make even the most optimistic administrator feel uneasy.
There are scores of questions that uncertain decision-makers need to have answered before entertaining the thought of automating any part of their lab's process. With the help of top experts, consultants and vendors, ADVANCE has answered those questions to help you feel confident and, hopefully, alleviate your fear of the unknown.
Can all automation systems troubleshoot, or is a designated person required?
This question asks if the systems are simple enough that all technicians are able to troubleshoot. According to experts, the answer is an emphatic yes. But as is the case with any new process or technology, some training is required to have a seamless transition.
"They [automated systems] are designed to be simple enough to be operated by virtually any laboratory professional," says Robin Felder, PhD, director, Medical Automation Research Center, University of Virginia, and an ADVANCE advisory board member. "Technologists who have been to a training exercise will be able to look at a screen and observe what is working, what isn't working, where the bottlenecks are and where the exceptions are showing up."
At ARUP Laboratories, more than a dozen trained employees work around the automation system as part of their daily job.
"We have trained employees to fix simple problems, such as a label or tube jam," says Charles D. Hawker, PhD, scientific director, Automation and Special Projects, ARUP Laboratories.
But the simple problems are only part of it. Automation equipment sometimes will have more complex problems that will require some technical capabilities. Thus, the typical automation customer in a hospital laboratory will most likely have to call in the service rep for the vendor. How often the lab needs someone like that will depend on the size and complexity of the system, says Dr. Hawker, who strongly encourages speaking with the vendor.
"Vendors should be able to give an honest answer on the frequency of things going wrong," he says. "The vendor could provide the names of other customers who have a system comparable to the one they are thinking of installing. Decision-makers can then call those people and ask them point blank how often their system goes down and how often they need to call in the service rep from the vendor."
Many vendors design their technically complex automation systems with a "keep it simple" philosophy.
"One of the main objectives of our Instrument Manager system is to make it simple and easy to use by lab personnel who are not necessarily information technology (IT) specialists," says Gregory R. Vail, president, Data Innovations. "All system maintenance is done automatically with no operator intervention, as there are extensive, easy to use, troubleshooting tools available to the user."
According to Auro Nair, PhD, vice president, worldwide marketing, Caliper Life Sciences, today's equipment is much more user friendly than people who are unfamiliar with automation may think.
"We have front-end user interfaces in which an individual can step up to these workstations and begin running them pretty seamlessly," he tells ADVANCE. "The people in these labs are knowledgeable in the scientific and application aspect, which is why they are in those labs. The automation just becomes a different tool to enable them to perform the analysis in a much more high-throughput, reliable and precise manner. A lot of what we've done, from a software standpoint, has to do with making automation much more user friendly."
Beckman Coulter takes a similar approach.
"We train just like we would any instrument platform, so anyone could become a key operator or lead person for it and it could be spread across as many different people as necessary," says Ron Berman, director, Automation and Information Systems Product Management, Beckman Coulter Inc. "Thus, it does not require a biomed person, as there is no unique skill set. It merely involves learning to maintain a different type of system than what they do already because most laboratories maintain their equipment anyway, and this is no different."
Some experts, however, recommend having a designated person to troubleshoot, provided the facility has the resources.
"Workstation-based automation usually can be diagnosed and supported by users up to invasive repairs; however, it is certainly better if a lab can assign an expert among the staff for each piece of equipment," says Douglas Gurevitch, MS, chairperson, Lab Automation 2006 Scientific Committee. "That spreads out the responsibility and gives the lab a consistent contact person for service, repair and training issues."
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