Todd B. Graham
Laboratory automation has come to full maturity since its introduction in the 1980s. From simply batching samples to run multiple tests to complicated systems that can run multiple modules at once while processing a variety of samples, laboratory automation is coming of age. Automation technologies have been key to reducing costs in the clinical laboratory while expanding the volume of testing that a given facility can perform.
As the technology for laboratory automation has evolved, the skills needed to succeed in a clinical laboratory have evolved with them. Prior to the passing of the Clinical Laboratory Improvement Acts of 1988 (CLIA), clinical laboratory positions commonly went to high school graduates who would learn on the job, rely on their manual or mechanical skills, and slowly develop the expertise required to operate the laboratory. Over time, these individuals were often sent for formal technical training, working their way up the ranks into clinical laboratory leadership positions.
With more formally educated clinical laboratory scientists entering the laboratory, a new standard for know-how is emerging. Certain duties, such as close consultations with health care professionals and deeper analysis of laboratory results, will only increase in importance as clinical laboratories produce ever-greater volumes of information. Laboratory roles and priorities will change as a result. As laboratory automation gains a greater foothold in the clinical laboratory, major challenges will arise for staff, but with those challenges will come certain opportunities.
HOW STAFF CAN BENEFIT FROM AUTOMATION
Reduction in labor is an unavoidable consequence of lab automation, but it does not always mean job loss. Labs can take automation and the corresponding reduction in manual labor as an opportunity to repurpose staff members for more challenging roles, which is often a boon to both the business and the staff. Staff may be deployed to help examine quality control and sample trends. They can become more involved in making recommendations for additional testing, reagent changes, and equipment servicing. Staff may find opportunities to develop new tools and assays. Being intimately familiar with the workings of the lab positions staff members to help innovate new workflows for better efficiency.
In some cases, automation affords health care facilities the opportunity to introduce additional departments, such as lab medicine customer service, or new types of labs with services that complement existing labs, opening up additional new roles for laboratory staff to move into.
As physicians are increasingly presented with greater volumes of testing information from more sources, they require greater and more specific guidance on the higher-level meaning of these tests. Guidance from laboratory professionals with deep experience in the possible interpretations of tests will be needed. Automation gives laboratory professionals greater availability for consultations with health care professionals. The lab professionals may suggest certain factors such as the patient’s medical history or complicating factors visible in other lab results that could impact the interpretation of a given test and help evaluate results of a given test in the context of other test results. Lab professionals can also discourage tests that may not be useful and steer health care professionals toward explanations and potential tests that would provide them with the information they need in order to answer key clinical questions.
Manual tasks, such as pipetting and plate streaking, can lead to operator fatigue and repetitive stress injuries such as carpal tunnel syndrome. Additionally, laboratory staff frequently expose themselves to biohazards when manually handling potentially infectious samples. A reduction in manual steps and handling inevitably reduces the risks of repetitive injury and exposure to biohazards, thus improving the safety of laboratory staff.
CHALLENGES STAFF WILL ENCOUNTER DUE TO AUTOMATION
Adjustment of roles
Over the course of their careers, experienced laboratory professionals develop a level of comfort with particular laboratory techniques. They master ways of performing these techniques that are highly efficient. They may also identify strongly with their ability to work with their hands. Some could take the introduction of automation as an affront to their skills. To avoid pushback against the introduction of laboratory automation, efforts must be made to include laboratory professionals as stakeholders in rolling out the technology. Getting their input on equipment purchases, upgrades, and modifications will help staff feel involved in the automation process from the get-go.
In the 1980s, students in the biological sciences focused on qualitative skills such as manual dexterity and identifying changes in color and clarity. This education has evolved over time to emphasize analytical and quantitative skills such as a deep understanding of statistics and the ability to code basic algorithms, meaning that less experienced professionals are now more likely to come in with the appropriate skills necessary to unleash the full power of laboratory automation. Meanwhile, more experienced professionals may need to brush up on analytical skills they might not have needed in the past.
Encouraging staff to take advantage of learning opportunities—such as classes in statistics and coding to improve their analytical skills—might help ease the shift. Training in statistics is especially powerful because it allows laboratory professionals to use their practical knowledge in new ways. Ensuring that staff are comfortable with new software and giving them the opportunities to make laboratory-specific tweaks is another means of giving laboratory professionals a stake in the process.
Rolling out laboratory automation will pose challenges to laboratory staff. From changes in procedure to emphasis on new skills, figuring out how to adjust to technologies intended to help staff is not always straightforward. However, with some thought and effort on the part of clinical lab managers, laboratory automation can be a boon to staff, unleashing their abilities to improve health and partner with health care professionals.