From standalone hospital labs to health systems and GPOs, different labs have different business models. Yet, they face similar operational challenges, among them finding and retaining qualified staff and identifying growth opportunities in response to declining reimbursement. These challenges, and the corresponding statistics about them, are all too familiar to many:
- The retirement rates of laboratory professionals across all major departments are at their highest since 2012.1
- The number of laboratory training programs has decreased by nearly 25 percent since 1990.2
- Due to PAMA, laboratories are experiencing the most significant reimbursement reduction in decades with private insurers expected to decrease rates as well.3
Meanwhile, the needs of aging patients continue to rise, resulting in higher volumes with fewer staff and resources to manage them. At the same time, organizations are increasingly measured by patient satisfaction and tasked with meeting value-based healthcare initiatives.
Multidisciplinary automation presents a strategic, tactical move organizations can make to answer multiple challenges across silos, disciplines, and staff. In fact, when tasked with faster turnaround times (TAT), consistent results, and lower costs in the face of higher volumes, laboratory automation can be instrumental to achieving necessary results—both for the laboratory and for the organization as a whole.
Gain buy-in and educate decision-makers
In the lab, technology can have a direct impact on patient experience, patient outcomes, and hospital reputation. Yet, the role the lab plays in supporting value-based healthcare goals may not always be recognized by the healthcare delivery organization’s administration and decision-makers. Nearly half of the laboratory professionals polled in a recent study by Siemens Healthineers identified gaining approval from C-suite executives as the second most challenging aspect of their project. The number one challenge? Budget. Seventy-two percent of those surveyed identified this as their main challenge.4 Ultimately, this may mean that getting support for a laboratory automation project will require buy-in from decision-makers, particularly those who can influence the project’s budget.
In fact, garnering support for a lab automation project is one of the first, and often most impactful, steps that can be taken before undertaking the project itself. Ask yourself, which decision-makers need to better understand the value of automating the laboratory? More than 70 percent of clinical decisions guided by test results5 rely on labs to consistently, and sustainably deliver high quality. Yet, a successful automation project can do much more—potentially increasing lab efficiency, improving TAT, and reducing errors. Thus, when approaching the topic with decision-makers, the goal is often increasing awareness not only about the clinical benefits of advanced technology but also the higher levels of patient safety and satisfaction that may be possible with faster, more accurate diagnoses.
In a recent study commissioned by Siemens Healthineers of 300 U.S. lab directors, internists, and emergency room physicians, more than 75 percent of respondents agreed that labs are a critical component of patient diagnosis and treatment. What’s more, nearly half of those respondents agreed that investments in lab technology would be very impactful to improve patient safety and outcomes.6 Keep in mind as well that U.S. hospitals that incorporate innovative medical technologies have Medicare Spending per Beneficiary (MSPB) scores below the national average.7 This is an important point about how innovative technology may help to reduce the cost of patient care.
Break down silos and engage stakeholders for support
A multidisciplinary automation project can provide significant, tangible benefits to numerous stakeholders throughout an organization. To do so, however, one needs to begin by identifying which stakeholders will be directly impacted by an automation project. Stakeholders can range from lab directors and purchasing decision-makers to IT specialists, quality managers, lab technicians, disciplines managers, and others. Garnering project support and buy-in is an essential step that is often overlooked. Quite simply, this is the human side of an automation project. Who will be impacted? Who should be given the opportunity to submit concerns and ideas? By communicating with these individuals and offering them the ability to comment and participate in this process, one can energize stakeholders, excite them about the project, and potentially turn them into champions for its success.
During the planning stage, both decision-makers and stakeholders should be aware of the goals of the automation project. These goals should be specific, measurable, and feasible against the project’s budget. Identify the project’s scope and specific objectives, noting what will be considered outside the scope of the project. Give stakeholders and decision-makers ample opportunity to comment and participate, and excite them by demonstrating how the automation project will make their roles, the laboratory’s offerings, and, ultimately, patient care, better.
Engage a workflow consultant and project manager
As you consider which stakeholders and decision-makers should be involved, a workflow consultant and project manager who can partner with you on your project may offer significant value. The best time to add a workflow consultant to the project team is during the early planning stage.
During this stage, an expert workflow consultant can conduct a thorough workflow analysis to identify process pain points and specific automation goals that can later be used to measure and validate return on investment (ROI). This methodical analysis of a laboratory’s productivity provides objective insights and solutions for improvement. By using process improvement methodologies and case studies from other projects with similar goals, workflow consultants can provide cost justifications to decision-makers and other stakeholders. Additionally, as the project progresses, informatics provided by the workflow consultant can enhance compliance and oversight capabilities for laboratorians.
Working in tandem with the consultant, an experienced project manager can coordinate the technical and physical aspects of implementation and resource management to help meet project milestones, time-related goals, and budget. During installation, the addition of project managers will help to ensure everything is in place to support a smooth implementation.
Evaluate current workflow processes and instruments
Laboratory operations performed day after day create muscle memory that will be disrupted during automation implementation. To limit this impact and ultimately improve laboratory efficiency and operations, a workflow analysis should be conducted prior to implementation.
A workflow analysis might entail evaluating the current workflow internally. Then, an experienced vendor can further evaluate the operational flow and develop suggestions for a customized solution with a full array of pre-analytical, post-analytical, and analytical systems for multiple disciplines.
Automated solutions with varying capabilities exist to support laboratories with their growing operations and to optimize the laboratory based on each facility’s unique needs. Total solutions encompass a variety of offerings, including equipment for sample management, a broad menu of assays, IVD analyzers, automation systems, and informatics. Such total solutions are designed to anticipate and address the emerging needs of clinical laboratories. Automation can also help provide a single point of entry for multiple testing disciplines, allotting for future growth capabilities without having to significantly increase footprint. In addition, expanded capabilities can accommodate menu and volume growth.
Recognizing total lab automation can be a significant investment to undertake at one time. As such, manufacturers have deployed a number of resources and affordable solutions to segue laboratories into automation. Innovative instrument features such as automated quality control and calibration, sophisticated vision systems, intelligent sample management and test scheduling, and bidirectional magnetic sample transport technology optimize the workload for highly skilled operators. Less hands-on time for routine tasks maximizes existing resources to help refocus skilled attention elsewhere in the lab and reduces the need for additional operators as laboratory operations grow.
Further support for the case for automation includes ASCP study results—which revealed the increasing workload in the laboratory is compelling laboratory managers to hire lower level applicants immediately after graduation or candidates with bachelor’s degrees but not laboratory training.8 Lack of training can expose patients to significant risks; for example, failure to recognize critical results. With more than 70 percent of clinical decisions being guided by test results, the laboratory must progress to continue delivering quality results.5 With the right infrastructure, and software behind it, automation is meant to improve workflow efficiency, to improve TAT, and to reduce errors. By working together with an experienced vendor, laboratories can define their unique key performance indicators and automation goals, and implement proven workflows based on best practices to achieve measurable outcomes. The key is keeping communication open during implementation and beyond.
A laboratory automation project can be a complex change for an organization accustomed to operating in silos, particularly if the project will be fully integrated with IT and multidisciplinary analyzers. When implementation begins, traditional processes and muscle memory will be interrupted while the workload continues. Strong collaboration among staff, stakeholders, and decision-makers will be essential.
In fact, the success of laboratory automation hinges on detailed planning and cross-collaboration. By involving decision-makers and stakeholders throughout the process, common obstacles that result from miscommunication and/or ambiguity may be avoided. Be sure to predetermine communication channels and deliver regular updates. Once installation begins, communications will be even more essential. Determine how the team will measure success for each milestone and highlight those successes and milestones as they are achieved. Using the information provided by the workflow consultant, define how you will measure ROI to communicate the value and importance of the automation project. Be sure to continue to highlight successes as they occur both during and after implementation to continue to garner support and enthusiasm for the project.
Answer top-level goals
There will always be competing projects and initiatives within an organization that may take the focus away from the lab. Yet, when decision-makers and stakeholders recognize the impact laboratory automation can have on the quality of patient care, daily workflow efficiency, and revenue, they can become champions for the lab and its automation.
Successfully guiding a multidisciplinary laboratory automation project relies on exceptional communication, which includes identifying a measurable ROI. How to embark on these tasks will require planning, buy-in, and alignment across multiple stakeholders and decision-makers. To do so, leverage the expertise of a professional workflow consultant and laboratory project manager who can identify areas for improvement from the onset, note considerations to keep in mind, and provide informatics and insights gained from projects with similar objectives. During construction, keep in mind that local regulatory authorities and approvals vary, which can have a significant impact on the project timeline. Partnering with a vendor who is experienced in guiding laboratories through this transition will help to manage expectations, timelines, and costs. As construction and installation come to a close, be certain to initiate a change management plan to overcome resistance. An ideal plan will address the human side of automation to elevate fears, minimize disruption, and maintain workflow during the transition.
As a strategy, multidisciplinary laboratory automation can answer several clinical and business challenges. It offers the opportunity to increase accuracy and capacity, provide faster and more consistent TATs, and sustainably improve staffing efficiency. Further, improvements such as these can be critical to an organization’s top-level goals, including value-based healthcare objectives—raising awareness about your lab’s role in what matters most: patient care.
3. Jude. CMS Issues PAMA Final Rule That Aims to Cut Medicare’s Clinical Laboratory Test Price Schedule Sharply Beginning in 2018: The Dark Daily, July 18, 2016. https://www.darkdaily.com/cms-issues-pama-final-rule-that-aims-to-cut-medicares-clinical-laboratory-test-price-schedule-sharply-beginning-in-2018
4. Siemens Healthineers. 2018. U.S. Lab Automation Survey Results. Available at: ?
5. Cadogan et al., 2015; Lippi et al., 2016; Plebani, 2015; Rohr et al., 2016; Sarata and Johnson, 2014.
6. Siemens Healthineers. 2017. The Diagnostic Lab: The Hidden Jewel in the Health System. https://www.healthcare.siemens.com/magazine/mso-whitepaper-diagnostic-lab.html
7. Avalere Health LLC. 2015. The Impact of Medical Technology on Medicare Spending. p.3. http://avalere.com/expertise/life-sciences/insights/new-study-finds-average-medicare-spending-for-top-technology-hospitals-matc
8. American Journal of Clinical Pathology, Volume 149, Issue 5, 29 March 2018, Pages 387–400, https://doi.org/10.1093/ajcp/aqy005