Robot arm in a clinical lab with test tubes for diagnostics assays.
Sophisticated instrumentation requires sophisticated professionals to operate and respond to problems in the correct manner.
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Automation in the Clinical Laboratory

Should lab staff be concerned about the increased use of automation?

Angela Tomei Robinson, MS, MLS(ASCP)CM

Angela Tomei Robinson, MS, MLS(ASCP)CM
  • Laboratory advocate
  • Laboratory advisor/ consultant 
  • Adjunct professor 
  • Past associate administrative director of pathology & laboratory medicine 
  • Past LIS manager / past supervisor 

Automation is a major part of laboratory medicine. With the increased use of automation in health care to alleviate high workloads and improve workflows, staff are understandably concerned about its impact on staffing.

What is laboratory automation?

In general, laboratory automation involves multidisciplinary strategic technologies comprising of varied laboratory equipment and analyzers sophisticated instrumentation often interfaced with computers.

When did automation become part of the clinical laboratory?

The first true stand-alone instrument (not machines that are equated with manual laboring) was recorded in the laboratory in 1957. The Clinical Chemistry Autoanalyzer I used continuous flow analysis (CFA). By 1969, the SMA (Sequential Multiple Analyzer) debuted and next came the SMAC (SMA with Computer) by 1974. With each generation, the instruments increased in size and capabilities.  

In the early 1980s, a revolution began when the first fully automated laboratory emerged and automation spread steadily throughout the 20th century. Advances in laboratory automation evolved and integrated into all aspects of laboratory medicine from preanalytical (collection/receiving/storage), analytical (testing), and postanalytical (archiving/reporting) processes. Laboratory information systems and management systems (LIS/LIMS) enhanced automation. Today, almost every laboratory area has some form of automation assimilated into its process.

Why automation?

As laboratory methodologies became more specific and specialized—with added attention to the value of laboratory results—the volume of orders increased along with diversified test menus. Automation generally eliminates tedious time-consuming tasks. 

Automation improves laboratory ordering/testing/reporting. This is accomplished through higher throughput, higher production rates, increased productivity, efficient use of reagents and materials, and standardization, which decreases the frequency of outliers with reduction in errors, resulting in improved turnaround times (TAT). 

Overall, automation reduces production costs with a positive impact on service to patients while creating a safer environment for staff.  

How does automation affect workplace staffing?

The main aim of automation is to boost efficiency and reliability and ostensibly reduce the need for increased labor. Automation has been reported to reduce error rates by more than 70 percent while also reducing staff time per specimen collection by 10 percent.  

However, despite viewing health care as a corporate business with a keen focus on cost savings, health care is still patient care, with at least 70 percent of today's medical decisions dependent on the clinical laboratory.  

The laboratory professionals are the medical laboratory scientists and technologists and technicians who aid in the detection, diagnosis, and treatment of disease by performing and managing the high volume of highly regulated standards of laboratory testing.

The most important resource is laboratorians

While automation is an inevitable necessity to improve laboratory workload and workflow—i.e., getting more done in less time with less human intervention—the most important of all resources remains the human workforce. 

Though there are laboratory professionals proficient in manual processes that require hands-on techniques, performing repetitive tasks (such as manual pipetting, diluting, chamber counts, normal differentials, etc.) hundreds of thousands of times justified the need to reduce demands on professionals’ psychomotor skills to focus on higher cognitive levels of expertise (independent judgement).  

Advanced technology conclusively assists with the logic of work smarter, not harder, but the human factor remains irreplaceable in the clinical lab. Automation is just another tool to assist lab professionals with high volume processes by minimizing the behavioral input—it can never fully replace the cognitive expertise. 

Sophisticated instrumentation requires sophisticated professionals

Clinical laboratories on the forefront of improving patient care realize that automation not only saves time and money, but it also provides new employment opportunities for skilled medical professionals while optimizing the available workforce. 

Despite the increased use of automation to improve workload and workflow, laboratory medicine and health care continue to experience severe staffing shortages. Of occupations likely to decline in the next decades due to automation, medical laboratory scientist is not listed as one of them. In fact, the Bureau of Labor Statistics projects the employment of clinical lab technologists and technicians will grow by 11 percent from 2020 to 2030, which is faster than the overall average.

Laboratory Medicine continues to need media attention and public awareness and industry respect and legislative support to attract and recruit highly qualified medical laboratorians, as well as retain nationally professionally board-certified, and where applicable, government right-to-practice licensed medical laboratory professionals. 

In terms of automation, sophisticated instrumentation requires sophisticated professionals to operate and respond to problems in the correct manner. Medical laboratory professionals oversee and manage the specialized instrumentation while upholding the standards of quality control and quality assurance and providing preventive maintenance and troubleshooting. 

Therefore, when coordinated together, automating of repetitive tasks frees laboratorians to dedicate their cognitive expertise to generating accurate and reliable laboratory results for improved quality of patient care.