Can Robot Replace a Clinical Lab??

Kamalahasan Ravindradoss, GM - Business Operations, TechMed Health Center and DiagnosticsHeadquartered in Bengaluru, TechMed Health Center and Diagnostics is one of the fastest growing healthcare services company in India offering a wide array of tests across biochemistry, hematology, immunology, flowcytometry, immunohistochemistry, serology, and many other areas.

The use of automation and robotics has taken a prominent place in clinical laboratories around the world. Laboratories face huge pressure to produce faster turnaround times(TAT)and reduce human errors to improve patient care. Current technologies can automate specimen transportation, sorting, accessioning, and inspection. As a result of automation, error reduction rates increased, staff time per specimen collection is reduced, patient safety is increased, and reduction in TAT

Automated Phlebotomy: You should have heard about 'Veebot's Phlebotomist’, introduced by the company Veebot for automated phlebotomy which working with 83 percent accuracy. This instrument would locate forearm veins and then chart the trajectory for a needle-wielding venipuncture robot. A million needle stick injuries are reported each year, can be avoided

Total Laboratory Automation(TLA): TLA consists of a specimen sorter that can sort specimens by analytical needs and transport specimens requiring serum or plasma testing to an automated centrifugation station for processing. Following sample separation the serum or plasma is then transported for sampling to various chemistry and immunoassay analyzers. The sorter can also identify whole blood specimens and convey them to automated instruments for complete blood counts and other hematology testing. Remaining specimens are automatically sent to racks that are specific for each analytical platform. These specimens can then be manually transported and inserted into the instrument of choice. Automation technologies are now more common in sample collection, centrifugation, accessioning, sample inspection, transportation, and more

Preferred Layout of the Laboratory
The ideal physical plant and layout for an automated clinical laboratory is a linear 'bowling alley' design. Specimen arrivals
should take place at the proximal end of the laboratory. Accessioning can occur immediately after unpacking. The automated sorter should be readily accessible at the end of the accessioning line. Completed specimens should be automatically stored at the distal end of the laboratory conveyor belt(May be required for repeat,or add-on testing without human intervention). Automated specimen refrigerators and freezers are available that are capable of performing these tasks. Automated aliquoting and labeling systems,as well as biorepository-sized automated storage systems are widely used in research labs.

Delivery and storage of reagents is ideally accomplished in a bank of refrigerators /freezers with doors on both sides of the laboratory installed parallel to the analytical systems they serve.

Stocking occurs from the back of each unit and retrieval of reagents from the front. Finally, reagent packaging waste should exit the laboratory at the distal end,accessible to automated pickup carts and vehicles.

Automated Specimen Separation: Ideally, sample separation should be done at the point of sample collection and incorporate automated labeling.

Specimen Transportation: Human and robotic courier services have inflexible pickup times and delays, while pneumatic tube systems have potential for specimen damage and limited carrying capacity.

Automated Specimen Delivery Using Mobile Robots: The robot can automatically deliver its payload and continue service without having to interrupt a laboratory technologist. In near future, drones(Flying robot) may provide both extra-laboratory as well as inter-laboratory delivery. A drone’s ability to rapidly move small numbers of specimens from a clinic to a laboratory can avoid automobile traffic delays. Inside a laboratory, drone deliveries can make a 200 foot journey in less than 2 seconds.

Pre-Analytical Automation: Now, pre-accession processors are introduced that can start with a bucket of randomly oriented specimens and finish with racked and processed specimens for downstream analytical processing. An automated specimen inspector is under research that examines critical specimen quality issues such as proper labeling, sufficient volume, and correct vial additive. In the future, the inspector will also determine the presence of lipemia, icterus, or hemolysis. From the inspector, nextgeneration linear motor conveyors will transport the tubes very rapidly: 3,000–18,000 tubes an hour moving at a rate of 20–120 meters a second. The system will also employ an automated sorting area where specimens can be automatically centrifuged or passed on directly to the hematology /coagulation robotic area. Essentially, the entire accessioning process will be automated so that time from phlebotomy to result will be 30 minutes or less.

Sample Labeling: The progression from manual labeling to 2 & 3D barcodes has dealt with many labeling problems and significantly cutdown on sample misplacement and mislabeling. New, electronic sample labeling technologies are now emerging, most of which are variants of radio frequency identification (RFID Tagging) through which sample are moved from patient bedside to analysis.

Scope in Future: Laboratory automation has become a well-accepted technology that allows high quality,efficient, and patient-centric operation with low operating costs. Automation should also be the foundation on which a Six Sigma program can be built and maintained. No wonder if a whole laboratory can be replaced by a Giant Robot assigned with all the above functions integrated.