Questions, Answers & Viewpoints

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Dear Editor:
The story in your February 17 issue about laboratory automation as viewed by an industrial engineer was fascinating. He did a great job of helping me understand how to look at clinical laboratory automation. However, you say nothing about the centralized/decentralized issue. Isn’t automation predicated on the concept of a centralized laboratory with a high volume of specimens? What happens if this “virtual laboratory” I read about actually does diffuse testing throughout my hospital system, ending the centralized laboratory as it exists today? What then happens to my investment in automated lab systems?
P.S., MD, NY, NY

Answer:
You realize the dilemma most laboratory directors face today. In the pursuit of lower costs, laboratory automation offers the promise of considerable savings. That requires answers to two questions.

First, can the proposed laboratory automation project pay for itself in a reasonable time period? Mark Smythe, the industrial engineer who authored that article on laboratory automation, says he generally wants a project’s return on investment to be 12 months or less.

He reasons that unexpected expenses always increase the cost of the project while extending the implementation time. He also has many alternative cost-saving opportunities and he doesn’t want to spend large sums of money that cannot be recovered in a short time period.

Second, if the “virtual laboratory” does begin appearing in the next 24-36 months, what does that do to your existing laboratory configuration, particularly if you have already invested heavily in automation?

Remember, even as automation vendors design equipment for lab locations with relatively high specimen volumes, competing instrument manufacturers are working equally hard to create miniaturized test instruments best suited to “point-of-care” or “near-patient” settings. Also, vendors are developing modular instrument systems which include self-contained automation.

Your answers to these two questions will drive your automation decision. If you determine that automation provides an acceptable payback for your laboratory and if your strategic outlook indicates your hospital system will be best served by point-of care/ near-patient testing capability, then you may want to defer any huge investment in laboratory automation.

Also, don’t overlook how the structure of laboratory organizations, and the technology which they incorporate, represent moving targets. Whatever information you base your decision upon will become outdated in six months to a year. It is necessary for you to regularly revisit your assumptions as you plan your options.

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