Automation to revolutionize the use of mass spectrometry, improving lab operations and patient care

Laboratorians have long recognized the unmatched clinical value of mass spectrometry (mass spec)—the diagnostic marvel well known for exceptional sensitivity, specificity, and accuracy. And while mass spec has been a fixture in forensic and reference laboratories for decades, this powerful, yet highly complex testing technology has been grossly underutilized due to operational barriers preventing seamless integration into the routine core clinical chemistry laboratory. In addressing this critically unmet need, emerging technology is on the horizon. The rise in automation of mass spectrometry is overcoming what was once an insurmountable challenge, clearing a path for more widespread, routine use of mass spec in clinical diagnostics. 

An analytical technique that measures the mass-to-charge ratio (m/z) of molecules such as peptides, proteins, and drug metabolites, mass spec helps identify and quantify compounds, as well as evaluate their molecular structure and chemical composition, with better specificity and sensitivity than other methods.¹ Historically a manual testing process requiring highly trained lab personnel, mass spec is often considered the gold standard in vitamin D testing, steroid hormone measurement, and immunosuppressive and therapeutic drug monitoring. Its unique ability to analyze small molecules at very low concentrations delivers an unparalleled level of detail to understand the underlying mechanisms of disease and a human body’s reaction to medication. Additionally, mass spec has less cross-reactivities and significantly fewer matrix effects and interferences than other detection methods. It is highly beneficial in improving the sensitivity of disease screening, therapeutic drug monitoring, and diagnostic testing.

Understanding the benefits of mass spec automation

Automated mass spec has the potential to revolutionize the way clinical mass spectrometry is used to enable better patient care, and ultimately, deliver the best possible outcomes for patients. With automation, more labs will benefit from precision mass spec testing in routine clinical practice, resulting in trickle-down advantages for healthcare systems and, of course, patients who stand to benefit the most.

Years of research and discovery in the making, mass spec automation is rooted in the development of paramagnetic particles, a chemistry technology used in the sample preparation step to separate the element to be analyzed from the rest of the patient sample. From there, automating the entire mass spec workflow involves numerous innovations in chemistry, biology, bioinformatics, and hardware development, all working in tandem to simplify mass spec’s sample-to-result interpretation process. The outcome is a user-friendly automated process that seamlessly integrates with the lab’s existing operations and requires no specialized training. 

Future mass spec automation will create countless benefits for today’s laboratories. Amid continuing laboratory staffing shortages, labs are expected to manage increasingly high numbers of samples at a faster pace, while retaining quality, delivering value, and improving cost efficiency. For labs facing these and other industry challenges, mass spec automation means simpler workflows that allow for more walk-away time, higher productivity, and increased efficiencies. 

Other major advantages of mass spec

Improvement in throughput and turnaround time (TAT)

With automation, mass spec can be completed without batching samples, cutting TAT from days to hours, in some cases. Running samples in random access will allow labs to offer 24/7 and STAT sample testing. Automation will also eliminate the need for lab specialists to process samples. Automating these processes could improve TATs and throughput by more than 25%.²

High-quality, standardized results

Lack of standardization is a major challenge in mass spec today. Labs are often faced with numerous instrument configurations, as well as varying pre-analytic and analytical methods, data acquisition conditions, calibration and quality control concepts, and methods to interpret results. This can make it very difficult to compare results between labs and even between instruments within the same lab.^3,4 Standardization of these parameters is extremely important for establishing and using reference ranges, and for the longitudinal measurements that are needed for patients who, for example, require lifelong therapeutic drug monitoring following solid organ transplantation. The availability of commercial mass spec-based assays that are anchored to reference measurement procedures and reference materials will allow for accurate and precise test results independent of time, patient, and location. 

Automated mass spec: The positive impact on patient care

While the benefits of automated mass spec start in the lab, there are a host of advantages for healthcare systems and the patients they serve. With significantly shorter TATs, physicians can diagnose disease faster and with more precision—a huge plus for high-acuity clinical units and intensive care. Even the clinical labs that offer mass spec today batch test and aren’t operationally equipped to run 24/7 mass spec testing. In rural areas without local access to reference labs, the need for on-site mass spec is even greater. In fact, considering the typical TATs of five or more days, many rural providers opt out of sending samples for testing because their patients can’t afford to wait that long for treatment. Rapid on-site mass spec testing will reveal a better clinical picture, supporting providers in treatment decisions. Healthcare systems will achieve greater efficiencies and be better positioned to manage patient care with a mass spec process that is automated, standardized, and integrated. 

As with all diagnostic testing, mass spectrometry’s greatest asset is its ability to improve patient care and deliver better health outcomes. To that end, automated mass spec supports timely and accurate diagnosis and may, in many cases, allow for earlier diagnosis of cancer and chronic diseases. Routine mass spec testing—more easily enabled through automation—is highly beneficial for certain patient groups. The technology adds value in treating patients with hormone receptive breast and prostate cancer, those with vitamin D deficiencies, organ transplant recipients, and patients undergoing therapy for tuberculosis. 

Antibiotic dosing with therapeutic effect is often difficult to achieve, especially in critically ill patients, and is yet another clinical arena in which automated mass spec can add value. Through accurate and precise drug monitoring, automated mass spec can reveal whether therapeutic concentration is reached and help determine if adjustments need to be made. This not only improves the likelihood of therapeutic success (while decreasing the risk of drug-related adverse events), but also helps limit the emergence of drug-resistant bacteria.

With the advent of automated mass spectrometry, laboratories are at the forefront of a paradigm shift in how this high-value diagnostic technique can be used to deliver better patient care. Automation will make routine mass spec testing possible, while enhancing lab workflows and addressing key operational and staffing challenges. The wider availability and more routine use of this technology will enable healthcare systems to provide better decision-making support for clinicians. As the future of laboratory medicine, automated mass spec provides sustainable, accessible solutions to tackle the healthcare challenges of tomorrow. 

References

1. Smith RW. Mass Spectrometry. In: Encyclopedia of Forensic Sciences. Elsevier; 2013:603-608.
2. Jannetto P. Eliminating the disconnect between people and processes. Clinical Laboratory News. Published November 1, 2015. Accessed July 18, 2025. https://myadlm.org/cln/articles/2015/november/automating-sample-preparation-for-mass-spectrometry. 
3. Vogeser M, Schuster C, Rockwood AL. A proposal to standardize the description of LC-MS-based measurement methods in laboratory medicine. Clin Mass Spectrom. 2019;13:36-38. doi:10.1016/j.clinms.2019.04.003. 
4. Seger C, Kessler A, Taibon J. Establishing metrological traceability for small molecule measurands in laboratory medicine. Clin Chem Lab Med. 2023;61(11):1890-1901. doi:10.1515/cclm-2022-0995.