Summary
A roundtable discussion focused on improving workflow efficiency in urinalysis, highlighting the potential of AI to enhance reflex testing by integrating test results with EHR data. While progress in implementing AI-driven reflex testing has been gradual, there is optimism about its ability to elevate urinalysis from a screening tool to a more diagnostic discipline. The discussion also touched on the underutilization of existing urinalysis analytes and the need for improved sample preservation methods.
March 2026—Workflow efficiency in urinalysis, sample preservation, the impact of new pharmaceuticals, and automation were front and center in a Jan. 26 roundtable on urinalysis, led online by CAP TODAY publisher Bob McGonnagle. The conversation begins here, and CAP TODAY’s guide to urinalysis instrumentation starts on page here.
Jason Anderson, in last year’s roundtable we talked about reflex testing and the potential usefulness of artificial intelligence in streamlining the process. What progress has been made in implementing reflex testing in urinalysis as you look across the board?
Jason M. Anderson, MPH, MT(ASCP), senior product manager, urinalysis solutions, IVD product marketing, Sysmex America: From my perspective, progress has been gradual, and many laboratories are still relying on the same traditional reflex rules. Reflex rules inherently aim to produce improved outcomes more efficiently. The opportunity lies in leveraging AI to integrate urinalysis test results with EHR data such as age, sex, other laboratory findings, prior antibiotic use, previous culture results, and other relevant clinical information. We’re just beginning to tap into how this combined data can drive more precise reflex testing pathways. It’s a promising frontier. By applying AI with advanced urinalysis methods, we can elevate what has traditionally been a screening-focused discipline into one with stronger diagnostic power, and that’s an exciting evolution for the field.
Matt Rhyner, many people would be thinking about using AI applications to define whether to go to a microscopic urinalysis, automated or otherwise. Does Beckman Coulter have initiatives in this area?
Matthew N. Rhyner, PhD, MBA, vice president and managing director, hematology and urinalysis business, Beckman Coulter: Our microscopic analysis and technology use AI to analyze and classify particles. The trend I see is more people are doing almost 100 percent reflex on these. When people obtain a workcell, there’s a high desire to do the chemistry and microscopy portions of the analysis. I see AI using those two pieces of information and providing something more definitive. A practicing physician colleague told me recently that he can no longer order a separate urinalysis chemistry and microscopy because it is one order now at his health care system.
The holy grail would be to skip microbiology urinalysis, though susceptibility testing will still be required for antimicrobial stewardship. That would be impactful, and we’re a long way from it, but I think that’s where the field will ultimately go.
You’re talking about the chemistry of urine and then using an automated visual interrogation to identify the particles?
Dr. Rhyner (Beckman Coulter): Yes. When the particles and chemistry are together, you can make an informed clinical decision to support the diagnosis, or if it’s a UTI you can recommend a specific antibiotic.
Mariann Amador, what do you think about the idea of reflex testing and interrogating the particles that are discovered and pairing them with the urine chemistries?