Tech Challenges Faced by Labs

The advancement of lab automation in the clinical diagnostics industry is continuing to expand as more suppliers enter the market with expanded automation options, and as shortages of lab personnel aggravate with increase in test volume in the industry

Dr GSK Velu

Imagine if there could be a time when the only human intervention in getting a blood test done would be the drawing of the sample and typing in the patient details in the system. Everything else right from bar code generation, labeling, transporting of samples to the processing area, loading on the processor, testing and report generation, report uploading on the website, intimation on report status over mobile to the customer etc is done automatically and on real time.

Diagnostics - Current Trends

The advancement of lab automation in the clinical diagnostics industry is continuing to expand as more suppliers enter the market with expanded automation options, and as shortages of lab personnel and increase in test volume in the industry require labs to perform more tests with fewer technologists. There are only about 300 labs worldwide that have installed total lab automation systems capable of handling all aspects of the testing process, from loading of the specimen tube to result generation for all the major lab disciplines (chemistry, immunochemistry, and haematology), while a number of others have automated one or more sections of the lab. The trend toward increased use of automation is expected to continue, with most of the growth in workstation-based automation rather than total lab automation

Large corporate laboratory chains provide fully-automated services at international accreditation standards. Although the industry is in the throes of consolidation nationally, there are a huge number of smaller players with manual processes, no accreditations and almost negligible automation. Currently, there around 40,000 labs in India. However, there is a glaring apathetic attitude towards regulations and accreditations. A dismal 59 out of the 40,000 labs are accredited which is less than one per cent of the total. Out of this, only 14 laboratories have CAP accreditation and over 45 laboratories have NABL accreditation. Moreover, out of these 40,000 labs, 10 per cent are inside hospitals, and only five are national pathology lab chains.

Challenges

• Clinical laboratories have the responsibility for providing a variety of tests that are crucial to the prevention, diagnosis, and treatment of disease. Currently, they are faced with a growing task. The half billion tests they now perform annually will double within the next five years under the stress of an increasing demand for health services. This is a critical problem whose solution lies in the automation of these laboratories since technical help is in short supply and would be too costly to employ in the amounts needed even if they were available.
• Most of the small and medium size labs still conduct tests on manual processors and diagnostics is still a technician intensive field of service.
• Given the fragmented nature of the industry and the lack of economies of scale to each player, IT and automation seems to be an insurmountable obstacle for the smaller players.
• Pre-analytical processing is one of the most technician-intensive aspects of clinical work, occupying up to two-thirds of the total time spent by personnel on clinical laboratory procedures. A majority of errors occur during this phase.
• Dwindling reimbursements, evolving technology and the persistent shortage of qualified technologists have stimulated decisions to automate an increasing number of pre-analytic functions. Several hundred clinical labs worldwide have even taken the giant stride of converting to total laboratory automation, based on strong evidence that automation not only heightens profitability but also improves quality, timeliness and lab flexibility.
• Sample tracking mechanisms, errors in result feeding, delivery of reports through email, data management and Laboratory Information Systems etc are common challenges that are faced by small and medium sized laboratories due to cost involved.
• Information dissemination to the medical fraternity and the field force is also another challenge faced by the diagnostic industry.
• Today's trend is to empower people with knowledge and make them health savvy. Direct communication with the patient is another challenge given the logistics and the ethical hurdles.

IT and automation is the solution to all challenges. Although it is an expensive exercise in terms of capital and manpower costs, it is necessary given the long-terms benefits such as quality reports, improved TAT, cost savings, reduction in pre-analytical errors etc to the organisation and the direct customers.

Challenges in Implementing Laboratory Automation

The approximate investment for Laboratory Automation (both pre and post analytical) is between Rs 1 crore to 3 crore. Complete laboratory automation is advisable for diagnostic facilities with an average workload of two million samples per annum. The individual facility would be the best judge to gauge the level of automation required based on workload and economies of scale.

Diagnostics - Future Trends

Organised Players are getting consolidated and the health insurance industry is opening for privatisation. Diagnostic centers are now harbouring advanced laboratory techniques like molecular diagnostics, nanotechnology and multiplex assays using micro arrays to provide better diagnosis. There is complete automation covering various laboratory segments from pre-analytics to final reporting. Healthcare has reached home with non invasive glucose monitoring and Point of Care Testing.

Comprehensive range of tools and reliability have helped easy diagnosis. Pathology is being serviced through telepathology and teleradiology which are getting recognised as specialised areas of medicine rather than "support areas".

The extended reach of healthcare due to the advancement in technology and creation of an E-world has led to remote diagnostics, surgeries, monitoring of chronic conditions; specialist conditions; email consultations for primary care; e-prescriptions; electronic health records and telemedicine, which has further led to borderless healthcare services.

The writer is Managing Director Metropolis Health Services
Email: gvelu@metropolisindia.com