With more and more healthcare decisions guided by clinical diagnostic results, clinical lab teams are constantly looking for ways to deliver more results, faster, without breaking their budget. The recent trend of molecular consolidation — running many different molecular assays on a single system — offers a reliable path to expanding a lab’s test menu and increasing throughput without investing in new test platforms.

Molecular consolidation is a significant improvement over the long tradition of buying a specific platform for each test offered by a clinical lab. These single-test technologies had to be implemented and validated individually, and each one required its own training and calibration protocols. In many cases, each platform also required a substantial financial outlay. For labs looking to provide more than just a few types of tests, having test-specific instruments was a major limiting factor in their ability to respond to patients’ needs.

Today, though, diagnostic platform manufacturers are addressing these challenges by designing systems that can be operated with many different assays. These flexible platforms might operate at low, medium, or high throughput, allowing laboratories to choose the system that best fits their testing needs. Instrument manufacturers offer many types of assays that can be run on the platform, making it easy for labs to expand their test menus simply by ordering new kits. Some platforms can even be used as the foundation for laboratory-developed tests, greatly increasing their flexibility and value to clinical labs.

At Far East Memorial Hospital in Taiwan, Dr Fang-Yeh Chu leads a team that recently implemented a diagnostic platform that enables them to run a broad range of tests. Their evaluation of the molecular consolidation approach has been very successful and was particularly important for meeting increased testing demand in the COVID-19 pandemic.

According to Dr Chu, molecular consolidation offered his team a number of key benefits.

Broad test menu. Implementing a flexible, high-throughput molecular diagnostic platform allowed the clinical lab to run many different types of tests at scale with excellent precision. They use it for virology assays, including HIV, HBV, HCV; transplant assays, including CMV, EBV and BKV; and respiratory assays, including influenza and SARS-CoV-2. They are now working to add HPV and MTB/MAI testing to their offerings.

Lean lab. While COVID-19 testing temporarily doubled the clinical lab’s staff size, the team is normally composed of just five lab members. Consolidating more tests onto a single automated platform that requires minimal hands-on time makes it possible for even a very small team to handle a wide array of testing needs.

Standardisation. Since all tests are designed to operate on the same instrument, training time for new tests is minimal. Once the team members learn the system, anyone can run any of the tests provided for it, making it easy to achieve higher precision. Dr Chu believes this is one of the most important benefits of molecular consolidation, and notes that training for the system in his lab was very easy. “My colleagues can use the device very quickly,” he says. He added that setup was very quick too, with the new assays up and running in the lab in less than a week .

LIS simplicity. Typically, adding a new test to a clinical lab involves not just validating the new technology, but also dealing with the inevitable challenge of connecting the new platform to the lab information system (LIS). But when new tests can be added to an existing platform, there is no need for additional LIS connections. Dr Chu says the system he chose connected to his LIS very easily. Now, new tests can be added at any time without requiring additional LIS setup.

Reliable support. With any new test platform, clinical lab teams take a gamble on the quality of technical support they will receive from the vendor. Some manufacturers have terrific support resources, while others can leave their customers hanging. By consolidating tests on a single system from a reliable vendor, clinical labs can avoid the possibility of inadequate support. “We always select the device based on the performance not only of the device, but also of the support team,” Dr Chu says, noting that his team has been able to get answers immediately for the system they adopted.

As Dr Chu’s experience shows, molecular consolidation offers many benefits. It allows clinical labs to broaden their test menu with ready-to-use reagents while streamlining their workflows, simplifying LIS connectivity and minimising training demands, all while maintaining excellent performance and without necessarily requiring new headcount.

Through partnership with instrument manufacturers that offer high-quality systems and fast and reliable support, consolidated molecular systems give clinical labs the power to scale up or down based on rapidly shifting demands, such as those brought about by current and future pandemics.

Interested in learning more? Check out this article about molecular consolidation and other trends to improve efficiency and lower costs in clinical labs.