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Choosing cost-efficiency in low-volume labs


cap today

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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