Of Automation, the Internet, and Other Curiosities

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IN READING THE FIRST DRAFTS of the stories in this issue of THE DARK REPORT, I was struck by the unsteady progress that’s been made in the lab industry by emerging technologies such as total laboratory automation (TLA) and Internet-based lab services during recent years.

How many of us remember the widespread belief, back in the first half of the 1990s, that fully-automated labs would eventually dominate the lab industry? Specimens would arrive at the lab. Once put into the automated system, no human hands would touch them again as they went through accessioning, on to the test instrument, then off to storage. It was also assumed that clinical laboratories which were first to fully automate would have a competitive cost advantage and would march off to market dominance.

As the old comic character Major Hoople used to say, “Harumph!” Those bold predictions of not-so-many years ago remain unfulfilled in today’s environment. The operators of the nation’s highest-volume laboratories, which include Laboratory Corporation of America, Quest Diagnostics Incorporated, still deem both the economics and management challenges of TLA as not yet ready for their highest volume facilities. The promise is, as yet, unfulfilled.

The same can be said for use of the Internet by laboratories. Back in 1999, Healtheon/WebMD held contracts with two of the three billion-dollar national labs to implement browser-based lab test ordering and results reporting. Advanced Health Technologies (AHT) had contracts with more than 60 healthcare systems to implement similar functions. Yet look at what happened during the past 24 months. WebMD acquired a lot of real healthcare businesses and found itself in a deep financial morass. AHT entered bankruptcy, was absorbed by CyBear, Inc. and has not been heard from again.

In my role as crusty old curmudgeon, I get to comment on the folly of vendors who tout solutions that may not yet be ready for prime-time. That’s a practice that’s aggravated laboratory executives and pathologists for years. But it must also be remembered that new technology never arrives in a “clean”? way. Both science and the marketplace are messy, muddled environments. Successes are always accompanied by setbacks, but progress is ever forward. TLA and the Internet are examples of this process. As they shake out their bugs, both technologies will eventually bring immense benefits to both the laboratory industry and the pathology profession.


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