In 2022, the immunology laboratory at Geisinger Medical Center (GMC) was faced with the seemingly impossible challenge of replacing their allergy and autoimmune testing instruments under an incredibly tight deadline: “From the time I got the financial approval to replace instruments, I had four months to go live,” says Elsie Yu, PhD, DABCC, FADLM, laboratory director, who had only recently inherited Immunology after overseeing Chemistry, Toxicology, Point-of-Care Testing, and Preanalytics for more than 10 years.
In the clinical world, from contract negotiations, IT security clearance, and instrument/method verifications to having tests built and added into EHR (electronic health record) interface for clinical use, four months is barely enough time. “In an ideal world, you’d want eight to twelve months for a project this size. This project was also complex due to the changes in test methodologies, particularly autoantibody testing. We barely had enough time to get through the method comparisons to review the data with the clinicians prior to going live,” says Yu.
To accomplish this goal, the GMC team worked closely with Thermo Fisher Scientific's Phadia team to identify the best solutions. For Immunology, an instrument consolidation process ultimately resulted in about $40,000 in savings of annual labor costs, as well as a 77 percent increase in testing volumes that brought in more revenue.
Instrument consolidation can help address today’s lab challenges
With the ever-growing demands for laboratory testing and a chronic shortage of medical laboratory professionals in the US and abroad, laboratories must continuously evaluate and improve their workflows and productivity. To accomplish this, today’s laboratory leaders are looking to vendor–laboratory partnerships to help them consolidate their testing, as well as evaluate their workflows.
Getting buy-in from staff
Ensuring you have buy-in from laboratory staff who actually work in the laboratory and use the instruments is key to successful consolidation. “They need to know that they’re part of the decision-making process,” says Yu. “If they don’t agree with the changes, it’s not going to work.”
Before committing to a new platform, conduct demos with different companies and instruments to evaluate their fit with your laboratory and testing needs.
When looking to replace their instruments, the GMC immunology laboratory team participated in instrument demos and were most impressed by the workflows and support provided by Thermo Fisher Scientific’s Phadia team. To consolidate most of their allergy and autoimmune testing, the lab brought in two Phadia™ 250 and Phadia™ 1000 systems to replace six existing instruments.
“My team is super happy with all the support they have received. The support person was on site to help us validate the instrument, and train and educate the team on all the details like reagent storage and management,” says Yu. “All the little tips they gave us were really helpful.”
Making data-driven decisions through workflow analysis
As part of the consolidation process, workflow analysis studies can help laboratories assess their current costs, processes, and equipment to identify specific ways to improve, such as optimizing floorplans and laboratory layout. Instrument consolidation can also help reduce turnaround times, manual labor, and reagent waste.
“We've seen such a high need because there's such a shortage of staff across the country,” says Jessica Murphy, MLS(ASCP)CM, senior technical laboratory educator, ImmunoDiagnostics, at Thermo Fisher Scientific. “Many labs don’t have the resources or staff to conduct workflow analysis studies in house, so we've created a role dedicated to workflows and supporting our customers.”
“For Geisinger, we conducted a workflow analysis impact study in May 2022,” says Murphy. “They were running six different instruments for all of their autoimmune disease testing, and one manual bench for IFA assays, so seven areas total.”
“We interviewed the technologists, recorded reagent utilization, time spent at each instrument/bench, and the physical layout of the lab. We used this data to produce a baseline, then conducted another study in 2023 after they had brought in the Phadia systems.”
Instrument consolidation produces real-world results
The workflow analysis study showed that going from seven instruments using four different methodologies to four instruments with two methodologies significantly reduced the time technologists spent walking to and from different areas of the lab every day, reduced daily manual labor from 6.5 hours to 2 hours, and produced savings of one full-time laboratory employee. In other words, the consolidation process saved the laboratory about 23 hours a week of manual labor and about $40,000 a year in labor costs.
Other savings included an 80 percent decrease in the number of PC interfaces, a 71 percent decrease in calibrations, a 67 percent decrease in the hours spent managing inventory, and a 59 percent decrease in reagent storage space.
Working with vendors on the consolidation process also helped the laboratory not only cut costs but free up resources to bring in more in-house testing to support allergen and autoimmune diseases.
“With the increasing prevalence of these diseases, laboratories must continue to meet growing testing demands while providing high-quality patient care, as well as meet their financial goals and remain profitable,” says Murphy. “New testing platforms, including more automated systems, can help laboratories meet these goals and even improve testing sensitivity, specificity, and accuracy, which can enhance workflow efficiencies and reduce hands-on time as well.”
For GMC’s immunology laboratory, working with Phadia on the workflow optimization and consolidation process, as well as adding more in-house allergy and autoimmunity testing through the new platforms, resulted in a 77 percent increase in testing volumes, ultimately bringing in more revenue.
Autoimmune disease tests
Allergic disease tests
|Table 1. Testing volume comparison of pre-workflow and post-workflow analysis at Geisinger Medical Center’s Immunology Laboratory. Data source: Thermo Fisher Scientific.
Ensuring a successful consolidation process
“In the end, we chose two different go live dates to make the transition easier for everyone,” says Yu. The lab started with running the autoimmunity testing systems, then after about a month, brought in the allergy testing. By staggering the go live dates, this allowed lab staff to slowly adjust to the new platforms and the new testing menu.
“But it’s not just about the instruments,” says Yu. “It’s important to ensure you have a good partner to work with on this process. I’ve worked with many vendors, and the Phadia team are exceptional. It’s not just about the product—I appreciate the partnership and support.”
“Every lab is different, so we work hard to understand the specific needs of each laboratory,” says Murphy. “Building trust and communication in the vendor–laboratory partnership is vital to successfully optimizing lab workflows to improve productivity.”