Laboratory

Automation
DR. MARWA IBRAHIM KHEDR, MD
L E C T U R E R O F M E D I C A L B I O C H E M I S T RY
C L I N I C A L PAT H O L O G Y S P E C I A L I S T

DR. MARWA IBRAHIM KHEDR, MD

What is Automation ?
Automation is the use of various control systems for
operating equipments and other applications with minimum
human intervention.
The use of automation in clinical laboratory enables to
perform many tests by analytical instruments with
minimum use of an analyst.

DR. MARWA IBRAHIM KHEDR, MD

Historical Background :
First automated analyzer was introduced by Technicon in 1957
It was a continuous flow, single channel , sequential batch
analyzer capable of providing a single test result on approx. 40
samples per hour.
Next major development occurred in 1970 with introduction
of Automatic Clinical Analyzer.
Most recent milestone in chemistry is the development of an
analyzer having combination of chemistry and immunoassay
into a single modular analyzer.
DR. MARWA IBRAHIM KHEDR, MD
Types of Automation :
Total laboratory automation
Subtotal automation (modular integrated automation)
Stand-Alone system
Auto-analyzer
Closed automation
Open automation
Discrete analysis
Random access analysis

DR. MARWA IBRAHIM KHEDR, MD

Benefits of Automation :
1. Effectively lowers the cost per test

2. Minimizes the variation in results

3. Coefficient of variance is reduced and reproducibility is increased.

4. Workload is decreased

5. Small amounts of samples and reagents are used decreasing the cost of consumables.

6. Reduce turn around time (TAT)

7. Increasing the quality of work

DR. MARWA IBRAHIM KHEDR, MD

Total laboratory automation :
Laboratory automation consolidates the control of multiple different analytical
instruments to a smaller number of operators, thus reducing the costs
in laboratory testing.
Total Laboratory Automation (TLA) is an automation system for the
performance of highly repetitive tasks in the Laboratory.
TLA is the most recent and most exciting development in Clinical Laboratories.
It consist of 3 main parts :
Pre analytic phase (sample processing)
Analytic phase ( chemical analysis)
Post analytic phase (data management)

DR. MARWA IBRAHIM KHEDR, MD

Important Considerations :
Economic and reliable operation
Reduce human resource cost
Lab space (cost of space renovations)
Up-gradation/ menu extension
Service back up
Availability of on-site biomedical engineer
Standardization of specimen tubes

DR. MARWA IBRAHIM KHEDR, MD

Automated analyzer :
Specimen identification
Specimen preparation
Chemical reaction
Data collection
Analysis

DR. MARWA IBRAHIM KHEDR, MD

Pre Analytic Phase :
The pre-analytic testing phase occurs first in the laboratory
process.
This phase may include specimen handling issues that occur
even prior to the time the specimen is received in the
laboratory.
Important errors can occur during the pre-analytic phase
with specimen handling and identification.

DR. MARWA IBRAHIM KHEDR, MD

Steps of Pre-Analysis :
It includes
Specimen barcode
Data entry of patient
Transportation of specimen to specified area.
Loading of specimen on track
Centrifugation
Decapping
To the analyzer

DR. MARWA IBRAHIM KHEDR, MD

 Steps Automated
in the Diagnostic Laboratory

Post-Analytical Pre-Analytical
prepare order
collect sample
transport to lab
Sample retrieval
accession sample
store samples

dispose of waste centrifuge

post-sort decap tubes

transmit test results pre-sort/aliquot

technical validation transport to analyzer

Analytical

DR. MARWA IBRAHIM KHEDR, MD

 Analytic phase :
The second phase is the analytic phases. This phase includes
what is usually considered the "actual" laboratory testing or
the diagnostic procedures, processes, and products that
ultimately provide results.
It includes
Input / output module
Tube storage module

DR. MARWA IBRAHIM KHEDR, MD

1- Continuous flow analyzer :
An automated chemical analyzer in which the samples and reagents are
pumped continuously through a system of modules interconnected by tubing.
It operates by introducing a sample and reagent(s) into tubing separated by
bubbles. Each segment of sample mixture goes through a mixing coil or other
tubing where chemical reactions occur. Various modules can be introduced to
perform specific chemical reactions.
There are significant carry-over problems and wasteful use of continuously
flowing reagents, which lead to the demise of these analyzers.

DR. MARWA IBRAHIM KHEDR, MD

1- Continuous flow analyzer :

DR. MARWA IBRAHIM KHEDR, MD

 Advantage :
Major use for certain test profiles (e.g. liver function, lipid function).

Single channel machines may be used for frequently requested independent analysis (e.g. blood
glucose, blood total protein).

Disadvantages:
The machine does not allow test selection; all tests must be performed even if not requested.

The instrument must be closely monitored all the time for air bubbles uniformity; reagent availability
and tubing integrity and most important of all carry over problems.

They are usually large in size and occupy large space.

DR. MARWA IBRAHIM KHEDR, MD
2- Centrifugal Analyzers :
 Samples and reagents are added in a specially designed
centrifugal type cuvette that has three main compartments.
Sample is added from the sample cup by auto-sampler into
the sample compartment of the centrifugal cuvette. The
reagent probe adds reagent into the reagent compartment
of the centrifugal cuvette

DR. MARWA IBRAHIM KHEDR, MD

2- Centrifugal Analyzers :
 Both sample and reagents are allowed to equilibrate to the
reaction temperature.
Mixing of sample and reagent occurs when the rotor
holding the cuvette is spun at high speed (4000 rpm) and
then sudden stop. The spinning causes the sample to be
added to the reagent while the turbulence caused by
sudden stop results in mixing of sample and reagent.

DR. MARWA IBRAHIM KHEDR, MD

2- Centrifugal Analyzers :
After mixing, the rotor is spun at 1000 rpm. The reaction
mixture is pushed horizontally to the bottom of the cuvette.
Principle of detection: It has clear transparent sides for
spectrophotometric measurement.

DR. MARWA IBRAHIM KHEDR, MD

DR. MARWA IBRAHIM KHEDR, MD
 Advantage
 Rapid test performance, analysing multiple samples. Batch analysis is a major advantage because
reactions in all cuvettes are read virtually simultaneously.
 Use small sample (as small as 2μL).
 Use small reagent volumes (250μL).

Disadvantage
 Only one test type can be performed each time.
 Each cuvette must be uniformly matched to each other to maintain quality handling of each sample

DR. MARWA IBRAHIM KHEDR, MD

3- Discrete Analyzers :
Separate testing cuvettes for each test and specimen.
They have the capability of running multiple tests on one specimen at a time or multiple
specimens testing at one time.
Most popular analyzers and have almost completely replaced continuous-flow and centrifugal
analyzers.
Separate reaction cuvettes, cells, slides, or wells that are disposed of following chemical
analysis are used. This keeps specimen and reaction carryover to a minimum but increases the
cost per test due to disposable products.
These analyzers are also called ‘random access’ analyzers

DR. MARWA IBRAHIM KHEDR, MD

3- Discrete Analyzers :
Advantage :
Each sample is treated differently according to the tests requested and programmed by the operator. E.g.
Sample 1 glucose, urea, creatinine and electrolytes. Sample 2 total protein, albumin, calcium.

DR. MARWA IBRAHIM KHEDR, MD

ADVIA® Automation
Siemens automation basically has three
aspects: Sample Manager, Track and
Instrument (in this case, IMMULITE,
ADVIA 1800 and Centaur XP)

The sample manager is the heart of the

system. It is the area in which you load
and unload specimens…therefore, only
one area to perform testing on three
different platforms (in this example). The
Sample Manager has capacity for 1000
tubes (separated into 10 trays of 100
tubes). Once you load a tray, the sole
robotic arm within the SM loads the
specimens, one at a time, onto the track.
ADVIA® Automation
Once they are put onto the track, the
barcode is read, the specimen is auto-
received (or accessioned) and then it is
routed to where it needs to go.

Once it has travelled to the appropriate

instruments and components, it is routed
back to the SM for post-analytical
sorting. In other words, when the SM
unloads tubes from the track, it sorts
them into pre-designated trays for
archival.
ADVIA® Automation

The track system is a two-lane, puck-

based, system. In other words, tubes
are handled individually (they go to
where they need to go ONLY)..and the
two lane system maximizes efficiency
because the tube ahead is never
impeding the one behind, as it all tubes
are routed to “divert lanes” or service
roads when a particular test is
requested.
Post-analytic phase :
The post-analytic phase is the final phase of the laboratory process. This phase culminates in the
production of a final value, result, or a diagnostic pathology report.
The computer is connected with the software of the equipment and report can be generated by
giving order.

DR. MARWA IBRAHIM KHEDR, MD

Four Q Model of Instrument
Qualification :
Design Qualification: documentation of required specifications of design and its
function. It also documents qualification of vender or supplier.
Installation Qualification: documented verification that system is installed
according to written and preapproved specifications
Operational Qualification: includes verification that system is operating in
accordance with preapproved and written specifications under normal and stressed
conditions.
Performance Qualification: it includes ongoing monitoring of performance, testing
for specified application and periodic updates about the analyzer.

DR. MARWA IBRAHIM KHEDR, MD

DR. MARWA IBRAHIM KHEDR, MD
DR. MARWA IBRAHIM KHEDR, MD
DR. MARWA IBRAHIM KHEDR, MD
Thank you

DR. MARWA IBRAHIM KHEDR, MD