CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
December 2020—What could improve urinalysis operations in your laboratory? That’s a question CAP TODAY publisher Bob McGonnagle asked Megan Nakashima, MD, of the Cleveland Clinic when she talked in October with him and two others: Carl Trippiedi of Sysmex and Matt Rhyner, PhD, MBA, of Beckman Coulter. Their conversation took place as CAP TODAY’s 2020 product guide to urinalysis instrumentation was taking shape. What they had to say follows.
Carl Trippiedi, can you tell us about the important news announced in August, which was Sysmex’s involvement with the Siemens Healthineers urinalysis business?
Carl Trippiedi, group marketing manager, hematology and urinalysis solutions, Sysmex: It’s a slight change of role in the marketplace. For several years Sysmex has made the UF-Series available to Siemens, which had a series of high-volume urine chemistry analyzers. They would adjoin the two instruments and sell them under the Advia Urinalysis Workcell, or AUW.
Trippiedi
Sysmex introduced its latest urinalysis solutions in the United States in 2019. That included the UF-5000, which is our third-generation urine particle analyzer. In addition, there is the UD-10, a urinalysis digital imaging system, which reflexes off the UF-5000, and the urinalysis data manager, or UDM, the processing unit that connects the two.
Urinalysis instruments product guide
The new Sysmex introduction in 2019 is branded as the UN-Series, and it was designed with many of the same principles as the XN-Series in hematology. It is modular and scalable. If you think about integrated urinalysis in the high-volume clinical laboratory, what was missing was the urine chemistry piece. So a number of discussions took place about how Sysmex would address that. Then it was announced in August that Sysmex signed an exclusive agreement to distribute and service the Siemens Healthineers Clinitek Novus automated urine chemistry analyzer in both the acute-care hospital market and the reference laboratory market. It gives us the ability to add the Novus as a module to our UN-Series.
In past CAP TODAY roundtables, there’s been an emphasis on workflow and scalability solutions and, in the case of urinalysis and even hematology, reducing manual work. Matt Rhyner, can you comment on the desire to integrate your urinalysis into one efficient system, with all elements in one place?
Matt Rhyner, PhD, MBA, VP and general manager of urinalysis, Beckman Coulter: There’s a push to automate the field of urinalysis, especially around reduction of manual work and reviews and having that high-throughput system that can do a great job on both chemistry and sediment analysis.
We partnered with Arkray a couple of years ago to work with the iQ200 imaging system that has terrific technology that we call automated particle recognition. Within the broader Beckman Coulter community, we just launched the DxA 5000, and there are opportunities to integrate urinalysis into a total lab automation solution. We haven’t done that yet, but there are more and more requests to understand the complete patient picture.
There are other opportunities to integrate urinalysis data with microbiology data to deliver better patient analysis.
Dr. Nakashima, can you comment on the move to integrate workflow and the move of urinalysis into high-volume laboratories that are good candidates for lab automation?
Dr. Nakashima
Megan Nakashima, MD, assistant professor of pathology, Cleveland Clinic Lerner College of Medicine, and staff hematopathologist, Cleveland Clinic: In terms of integrated workflow, we at the Cleveland Clinic main campus already have an automated system, so that change wouldn’t impact us as much, and we have a low manual review rate. A lot of our volume is filtered in from the region, but we also have many outlying hospitals and clinics that have their own labs, so there is still a space where we need to have smaller instruments, and if they can be more efficient with that type of scalability, then that’s attractive to a system. We are looking at total lab automation at the moment, and I’m not sure what benefits we would get from adding urinalysis to that system. The people I’ve talked to who have done this in other labs have, for the most part, kept urine off the main track, but it’s something to think about.
Dr. Nakashima, in the next year if you could improve one or two things in the operations of the urinalysis you oversee at the Cleveland Clinic, what would those be? If I gave you a magic dipstick and you could wave it and solve two problems that are headaches now, what would you like to solve?
Dr. Nakashima (Cleveland Clinic): Our instruments break down frequently, and that’s probably our major issue. It is a large-volume laboratory, so we push them pretty hard. The second thing would be more standardization of collection. For the most part, our preference is preserved urine or urine in preservative tubes and we don’t always get them that way. Some of the analyzers are not approved for preservative samples. So if you don’t have a high-complexity laboratory, you would not be able to run your samples that way. I wish the whole industry would move toward using preservative tubes whenever possible.
Dr. Rhyner