Today, with hundreds of successful lab implementations on record, the proven value of this technology can hardly be disputed. Multiple studies have validated automation's ability to deliver significant cost and labor savings—both clinically and operationally—to hospitals and laboratories of all sizes.
A Historical Perspective
When TLA was first introduced, many early adopting laboratories chose to integrate TLA solutions as part of their core lab re-engineering strategy. At the same time, they justified the cost with their plans for increasing revenue coming from an increase in outreach testing volume.
But in many cases, labs' adoption of automation preceded their actual gains in test volume, making their financial projections and ROI metrics difficult to justify.
Responding to this trend and subsequent slowdown of TLA sales, some automation manufacturers began focusing on front-end automation systems that streamlined the time- and error-intensive sample processing tasks such as centrifugation, aliquotting and sample sorting.
As more labs witnessed the benefits of these front-end automation systems, their familiarity and confidence with lab automation grew. With staff members on board and financial justifications firmly in place, these same labs soon began requesting higher levels of automation—specifically, the entire testing process from front-end sample accessioning through results delivery and sample storage.
Today's TLA Landscape
While several automation manufacturers have disappeared over the past two decades, many innovative suppliers remain—and the argument for adopting automation is as strong as ever.
By the end of 2005, about 25 percent of large hospitals in the United States had purchased some form of automation for their laboratories. Today, most of these labs are striving to use automation to grow their outreach programs and become more productive. In many of the smaller labs, on the other hand, automation is adopted because the lab cannot get enough skilled labor to keep the laboratory operating. In fact, TLA systems have been purchased by hospitals with less than 200 beds.
Regardless of the size of the laboratory, justifying an automation purchase can be relatively easy. Beckman Coulter has found that laboratories typically obtain a return on their automation investment within 18-36 months because they are able to benefit from less staff requirements while accommodating an increase in their workload.
Evolution of the LIS
Another factor that has accelerated the trend toward TLA is LIS maturity. Early on, LIS systems were ill-equipped to keep up with the demands and complexities of new systems. However, today's LIS systems (e.g., Cerner, Meditech, Misys and Soft/SCC) have improved greatly and now expertly process unique bar codes for each sample tube. These improvements lend additional support to TLA as a comprehensive lab solution.
Ongoing Laboratory Trends
Another reason for automation's popularity lies in the laboratory landscape itself. Long-running industry factors—increasing test volumes, heightened attention to error reduction and fewer available labor resources—leave labs desperate for cost-effective solutions. Consider the following facts:
- Shortage of lab technologists. In the United States there is a 14 percent vacancy rate among medical technologists; this critical shortage will worsen after 2008, when sizable numbers of professionals working in the field are expected to retire.
- Increases in test volume. Labs' test workloads continue to rise, driven in part by an aging population and exacerbated by some labs' expansion efforts. As a result, labs are seeking new ways to process their routine tests quickly and efficiently. In addition, labs that take on additional specialty work have fewer resources to handle routine testing and need assistance in processing everyday workloads.
- Cost containment. Clinical laboratories are under increasing pressure to operate as for-profit ventures that have decreasing costs as a main operational goal. This forces the need for improvements in staff productivity and the technological developments that reduce manual intervention, like automation.
- Reduction of medical errors. Recent industry news has awakened public interest in the rise of serious medical errors plaguing the healthcare industry. Not only does automation speed turnaround time, it helps notify clinicians of abnormal results and boosts laboratory safety by eliminating exposure to potential biohazards.
A Focus on Process Strategies
Due in large part to the growing popularity of Six Sigma and LEAN strategies, laboratories are more familiar with the concept and value of process improvement methods. As a result, many labs actively seek innovative tools—like automation—to help them improve process operations, cut costs and drive long-term efficiency.
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