8/8/2019 Laboratory Automation and Point of Care Testing

1/12

Laboratory Automation and Pointof Care Testing

8/8/2019 Laboratory Automation and Point of Care Testing

2/12

80% or more of the information a physician

relies on comes from laboratory results

8/8/2019 Laboratory Automation and Point of Care Testing

3/12

Benefits of Automation

Reduction of medical errors

Improved safety for laboratorians

Faster turn-around-times

Partially alleviates staff shortage

8/8/2019 Laboratory Automation and Point of Care Testing

4/12

Steps In Automated Analysis

1. Specimen collection and processing

2. Specimen and reagent measurement anddelivery

3. Chemical reaction phase

4. Measurement phase

5. Signal processing and data handling

8/8/2019 Laboratory Automation and Point of Care Testing

5/12

Specimen Collection and Processing

Barcoding

Types of specimens used in lab testing Whole blood

Serum or plasma

CSF

Urine

Stool

Joint fluids or various other body fluids

8/8/2019 Laboratory Automation and Point of Care Testing

6/12

Specimen & Reagent Measurementand Delivery

Random Access analyzer

All determinations done on one patient beforegoing to next

Do not have to perform all tests available, can

choose which tests

8/8/2019 Laboratory Automation and Point of Care Testing

7/12

Chemical Reaction Phase

Mixing

Wet or dry reagents

Separation

Incubation

Reaction Time

8/8/2019 Laboratory Automation and Point of Care Testing

8/12

Measurement Phase

Various methodologies to measure the

analytes in lab CLIA 88 mandates that when using a

moderate or high complexity automated

instrument you must run 2 controls every 8

hours of operation or once per shift whenpatient specimens are being analyzed

8/8/2019 Laboratory Automation and Point of Care Testing

9/12

Signal Processing and Data Handling

Hard copy

Visualize on computer monitor Autoverification

Interfaced with LIS

8/8/2019 Laboratory Automation and Point of Care Testing

10/12

Automated Analyzers

Choice of instrument based on several

factors: Volume of tests

Level of staffing

Cost of analyzer

Size of lab

Maintenance and operation costs

Turn-Around-Time Throughput

8/8/2019 Laboratory Automation and Point of Care Testing

11/12

Point of Care Testing

at the bedside or

near the patient

Reduced turn-around-

time

Cost

Maintenance of QC andQA

Connectivity to

Patients record

8/8/2019 Laboratory Automation and Point of Care Testing

12/12

Testing Complexity

Waived tests

S

imple, non-detrimental Moderate Complexity

More complex, usually automated (blood counts, routine

chemistry)

High complexity

Usually non-automated, complicated, require judgment

(micro, and blood bank)

Provider Performed Microscopy (PPM)