June 2003
Feature Story
Anne Ford
Cost-efficiency plays a leading role in any instrumentation decision.
But in a low-volume laboratory, it takes center stage. “The small
instruments by design have a higher cost per test than the machines designed
for large throughput,” says Jim Miller, general manager of Hemagen’s
clinical chemistry analyzer systems division. “And there’s
just so much you can do with the cost of the test.”
Without economy of scale on their side, low-volume laboratories must figure
out how to cut costs elsewhere without sacrificing accuracy or speed.
The chemistry analyzers in this month’s lineup—designed for
the low-volume lab—offer features aimed to do just that.
The technologist and technician shortage means that these analyzers must
require minimal hands-on time. “Even if you find a system that’s
extremely inexpensive to purchase, if it takes a lot of tech time to operate
it, it doesn’t result in cost savings for the lab,” says Christine
Forst, marketing product manager for clinical chemistry at Ortho-Clinical
Diagnostics. It’s helpful, too, if the system is user-friendly enough
that it doesn’t have to be operated by a medical technologist. Ortho-Clinical’s
Vitros DT 60-II system is “very robust—it can handle varying
skill levels,” she says.
Miller says that Hemagen’s Analyst benchtop chemistry system is
designed to reduce labor costs through its ease-of-use features. Instructions
on the analyzer use symbols rather than words. “You push a symbol
on the unit and it adds the sample, and you match that symbol to the symbol
on the test, so that it adds the right sample and diluent to the right
part of the test,” he says. “‘Go’ looks like your
index finger; ‘stop’ is a big X. It’s very non-operator-dependent.”
Toward the same goal, Nova Biomedical’s Stat Profile Critical Care
XPress has a touch-screen, says Ron Newby, director of marketing, “so
you can order the panels without doing a lot of programming.”
Reagent kit size is another financial hot spot for low-volume labs. In
these settings, buying in bulk usually doesn’t reduce costs—instead,
it often means that labs waste money by discarding expired reagents. To
address this problem, says Kathy Iozzino, senior marketing manager at
Alfa Wassermann, her company offers smaller reagent quantities for its
Ace clinical chemistry system. “Our reagent kit sizes contain volumes
which are appropriate for a physician’s office laboratory,”
she says. “You’re not forced to buy reagent kits with 1,000
tests at a time.”
In instrument size, too, smaller is often better. By freeing up valuable
floor space, smaller instruments can make lab operations more efficient
and cost-effective. Though small, Abaxis’ Piccolo chemistry and
electrolyte analyzer, says marketing director Ron Blasig, “can provide
comparable panels to that of a core lab. During a presentation to Emory
University Hospitals laboratory staff some time ago, I placed this little
Piccolo on their big instrument and said, ‘This will do everything
that does.’” Toni Perkins, marketing product manager at Dade
Behring, adds that her company’s instrument, the Dimension Xpand,
which “has a broad test menu of the most often ordered methods,”
is attractive to physician office labs as well as hospitals “because
of its small footprint.”
With its Synchron CX5 Pro analyzer, says product marketing manager Dan
Siegenthaler, Beckman Coulter addresses another cost factor for labs:
instrument maintenance and repair. The CX5 has remote diagnostic capabilities,
so if a lab makes a maintenance request, he says, the company can “dial
in through a modem and bring back what’s on the system to our computer,
and we can actually operate the instrument and do different test functions.
Often we can help fix problems right away over the phone.”
A more advanced remote diagnostics function is available now on Beckman
Coulter’s higher-volume analyzers, but the company hopes to feature
it on its low-volume analyzers in the future. The advanced function “monitors
the vital signs of the instrument—pressures, voltages, temperatures—24
hours a day, seven days a week, and transmits the data every seven seconds
through the Internet to a server at our facility,” says Siegenthaler.
“If a parameter goes outside a certain set range, it triggers an
alarm and sends an e-mail to the service manager, alerting him to the
existence of a potential problem before it even results in instrument
downtime.”
Meanwhile, Roche product manager Todd Atkinson thinks the next few years
will find small labs focusing on instrument consolidation as a cost-saving
measure. “They may have one or two people operating three or four
instruments,” he says. “If they can consolidate and eliminate
some of those extra instruments, they can tie up less time and fewer operators.”
Roche’s Cobas Integra 400 Plus features more than 130 assays, 32
open channels, and four ISEs.
CAP TODAY’s lineup of
chemistry analyzers for low-volume labs includes, in addition to those
mentioned here, abbott laboratories’ i-stat portable and 1;
act diagnostics’ pronto evolution; alfa wassermann’s nexct;
analox instruments’ gm7; awareness technology’s chemwell;
beckman coulter’s synchron cx4 pro; clinical data’s atac 6000,
8000, agii; nova’s nova 16; roche’s hitachi 912 coba mira
plus cc. vendors supplied the information listed. readers interested a
particular analyzer should confirm that it has stated features capabilities.
Anne Ford is CAP TODAY senior editor.
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