It’s no secret that the field of laboratory medicine is constantly evolving. Under relentless pressure to reduce costs, increase speed and improve quality, laboratory professionals around the world must also strive to meet the growing expectation for highly automated, ultra-efficient technology in the lab.

These challenges converge into a problem of resources and raise questions about of the role of humans versus machines in the future of medical laboratories.

How can laboratories incorporate and afford the steady advancements in medical testing and technology when time, budget and staffing are limited? What can be done to create the type of laboratory that is best for all stakeholders, now and in the future?

Some experts suggest that the answers lie in reinventing the way laboratory medicine changes—creating a world in which labs adapt to meet current and future demands by taking active ownership of what those demands should be.

Understanding the challenges in order to reframe the issue

As science, technology, financial pressure, societal expectations, workload, workforce and the work environment evolve, labs must adapt.

“The challenge for labs, especially in Thailand, is the changing technology, and other changes, whether they be human, technological or the ecosystem,” says Nitaya Chomngam, Managing Director at Professional Laboratory Management Corp (PROLAB) in Bangkok, Thailand. “Unless labs adjust to changes, there can be disruption.”

Trying to get ahead of the curve when most labs are struggling just to keep up may seem impossible. Yet some future challenges can be predicted based on current trends in laboratory medicine. Science is rapidly accommodating more precision and personalised medicine capabilities. Additional changes likely to confront the field include the genetic prediction of health risks and an ever-increasing public expectation for extreme accessibility of results—and instant feedback—via mobile and digital tools.

“[Artificial intelligence] (AI) is inevitable. Mobile phones can be used for almost anything. So, in the future, we need to adjust to be more personalised,” says Chomngam. “All labs need to adjust and adapt to changes. They need a new paradigm. It is not easy, but it is necessary. And we need to start soon, before it is too late.”

Futuristic laboratory medicine also opens up new options for the type of objective medical data that will be collected and analysed—including types that laboratory systems are not currently equipped to analyse.

“I am concerned [about]… how to manage and utilise time-series digital health information collected with sensors from the living body for the purpose of healthcare of individuals, including automated diagnosis, remote care, home care and so on,” says Masato Maekawa, Professor in the Department of Laboratory Medicine and Director of Clinical Laboratory Medicine at Hamamatsu University School of Medicine in Japan. “Here, personal health records are also closely involved.”

Digital laboratory reporting systems that coordinate with electronic medical records and personalised monitoring apps and equipment offer tangible, prospective goals for merging present lab science with its future.

“Simply yielding data does not suffice. Unless the data yielded are quality assured, there may be trouble or problems when therapeutic strategy is devised on the basis of data,” says Maekawa. “Quality assurance is always an important topic.”

Making newly generated data clinically useful—whether it is from personal health apps, precision genetic testing or state-of-the-art equipment—is a challenge. Clinical decision-making depends on the quality of the data and its ability to be interpreted for physicians and patients.

“I think a forward-looking lab has to adjust to change, utilise IT and use labour-saving automation to increase efficiency,” says Chomngam. “Also, do not disregard the human aspect, because people have to manage things. Automation is not the answer to everything.”

A laboratory that plays an active role in filtering such data to identify and understand what data merits action, and what is just junk, will increase its value in the long run.

Carving out a future for humans in laboratories

The ability to predict challenges opens a door of opportunity for laboratory medicine. Part of the problem, some laboratory leaders believe, is that laboratory medicine is largely reactive, rather than proactive—meeting demands as they arise, rather than defining its own course to solve problems.

Today’s lab managers have a responsibility to identify where it is critical to preserve the human touchpoint, by understanding where it is most needed.

“It seems essential that, while the testing job is assigned to AI or robotics to the extent possible, technological innovation is promoted towards the goal of standardisation and harmonisation of all processes of laboratory tests,” says Maekawa. “If that can be achieved, laboratory technologists can focus on the kind of work before and after the test that is possible only for humans.”

This involves cementing the role of laboratory specialists in thought-intensive processes that demand the human nuance and perspective. It is this judgment and interpretive ability that no machine can currently mimic.

“We need to have more interpretative command,” says Mohd Jamsani Bin Mat Salleh, MD, Head of Chemical Pathology Unit at Hospital Pulau Pinang Georgetown in Malaysia. He argues that laboratory professionals must keep firm ownership of quality control and lab reputation in a technology-dominated field, with the responsibility to determine which results are valid and which are suspect. “We [need to] perform all investigations and different studies before we release the result. The final result should be a genuine result that can be trusted.”

Adjusting to increased information technology (IT) in the lab will be essential. Thankfully, this offers the chance to improve and design how technology can work for laboratories, clinicians and patients.

“I think the most important thing that we can do is not just think of all these things within the box. We even don’t have to think of it out of the box. But we should think without the box,” says Dr Jamsani. “It means that we don’t just think that ‘This is the framework: we should work with the financial pressure, with the problem with the workforce.’ Instead, we are looking at something which is able to overcome this issue and problem. To make ourselves present and to make sure that whatever resources we have can be optimised by having true consolidation [and] integration.”

Opportunities for proactive change include expanding staff education and inter-professional interaction, implementing systems that target the anticipated future trends toward personalised medicine and digital communication—including in information security—and the harnessing of laboratory technology to optimise human goals of standardisation, error reduction and efficiency.

Implementing unique adjustments to the changing environment helps reinterpret the encroachment of technology into laboratory medicine as a challenge that staff can run with, rather than fall prey to. It’s a new paradigm that advances and reinvents the field of laboratory medicine independent of—not in spite of—the increasing pressures on it to meet others’ expectations. It involves solving the field’s problems with self-made solutions.

Some labs involve their staff on this sort of idea generation. Practically speaking, it’s good for individual labs and employees as well as for the future of lab management.

“At PROLAB, we encourage staff participation in helping us manage and reduce lab cost,” says Chomngam. “We have [a continuous quality improvement] project in which staff can initiate what they think would work. If their initiatives actually reduce the company costs, we give a portion of that back to them.” 

Ushering in the new paradigm

Thinking without the box, rather than inside or outside of it, can help forward-looking laboratory leaders identify solutions and a new paradigm for laboratory medicine. A revolution in the field doesn’t need to be driven solely by external pressures, but can instead result from active internal evolution and advancements, including good leadership and teamwork.

“Labs cannot sit back and react. They need to be proactive and focus more on the preventative side of things,” says Chomngam. “Stopping short-sightedness could be valuable to opening opportunities for technology in the lab—thinking past its current role to the bigger picture of what we would like it to do. Look long-term. I believe the cost of prevention is less than the cost of a cure. So let’s focus on the prevention.”

It is important for leaders to ask themselves what they would like to be able to achieve with their lab, not just what they need to achieve. Thinking beyond the immediate space in which you work may be essential for inventing solutions that make sense both now and for the events to come.

“Instead of constantly telling [administrators] ‘We need more money,’ we are innovatively thinking of ways of how we are able to improve our performance by using whatever existing resources we have,” says Dr Jamsani. “So it’s not a limitation for us, but instead, it is a channel for us to do more, and better.”

This type of mindset bodes well for the future of laboratory medicine, which has no end in sight for its evolution in complexity and value to human health. How lab leaders react will define how well the field can meet the challenges that come along with change—and create a better future at the same time.

“Large waves will come one after another from now on,” says Maekawa. “We should make efforts to ride on the waves skillfully—without being swallowed up by waves—and to create our own waves.”

Key Takeaways

• Proactively identify anticipated future needs and challenges for your lab and study them together with current challenges. Search for ways to address both present and future needs with combined, creative solutions.
• Maintain your lab’s focus on quality and customer service, so that all changes you make fall in line with your lab’s core values and purpose. Explore all potential opportunities for updates and adaptations in light of how well they serve the achievement of your lab’s key goals.
• Enlist staff and colleagues to generate ideas that offer “without the box” problem-solving, and keep lab staff engaged in education, leadership, industry and technology. This will help your lab evolve along with the field as a whole—while keeping the expertise of your human team members in the spotlight.