Article
Even before the emergence of SARS-CoV-2, molecular laboratories were facing mounting pressure to boost efficiency, lower costs and expand molecular test menus without adding more resources. The advent of COVID-19, though, has pushed many molecular labs to the limit. Here, we consider the major headwinds facing these labs and some tried-and-true options for addressing them.
Current Challenges
Scale. Molecular test results are being used to make more decisions in healthcare than ever before — from confirming a diagnosis to selecting the optimal treatment to long-term monitoring of patient status. Even amid the backdrop of lab decentralisation in many countries, this puts pressure on each laboratory to perform more tests while returning results quickly.
Costs. While reimbursement policies vary widely among countries, one trend is nearly universal: trying to reduce costs associated with healthcare. Laboratory teams are under tremendous pressure to keep costs in check even as technologies become more complex and clinical tests are expected to generate more data.
Clinical results. While simultaneously reining in costs and increasing overall lab throughput, laboratory scientists must also maintain their core focus: generating the most accurate and reliable clinical results possible. This can require time-intensive validation studies, development of new assays and continual monitoring of the diagnostic landscape to ensure that the lab is offering the best possible tests.
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Getting Ahead
There are several ways to address these challenges in the molecular lab, and they can be grouped into four general categories. The most important thing for any clinical lab team looking to make progress is to remember that it is not necessary to implement all of these changes; adopting just one or two can make a real difference.
Automation. This is the single best place to start for resource-limited labs that need to boost efficiency and reduce per-test costs. While molecular automation is often associated with large reference labs, it can actually be a great fit for low- to medium-throughput facilities. The adoption of even one automated platform for some of the most commonly requested molecular tests will not only allow labs to scale and improve reproducibility of results, but also — and perhaps more importantly — free up technicians’ time so they can focus their skills on higher-value tasks that are not amenable to automation. In the ideal situation, molecular labs can use automated platforms for the vast majority of tests, allowing staff members to spend their time on the most specialised or complex lab needs.
How to get started: Survey your laboratory operations to pinpoint which tests are most frequently performed, or which take the most time. Then, look into whether automated platforms could handle those tests for you.
Consolidation. For the most efficient molecular operations, automated diagnostic platforms should offer flexibility. Typically, that means a single platform will be able to run a broad portfolio of different tests — the days of having to adopt a specialised instrument to run a single type of test are in the past. In addition to running many kinds of assays, the best automated platforms will allow laboratories to develop their own tests so a single workflow can be used for both in vitro diagnostics and laboratory-developed tests. This makes it much easier for labs to expand their test menus as needed.
How to get started: When evaluating automated diagnostic platforms, be sure to find out how many different types of tests each platform will support and see how those options compare to the test menu your lab offers. The greater the overlap, the more useful the platform will be.
Integration. This step may not be feasible for all laboratories, but it definitely makes a difference when it can be implemented. Integration brings together the information management tools and processes to make the entire laboratory workflow more seamless across departments, from clinical chemistry to the molecular lab and everything in between. Using a single system to connect everything from the pre-analytical workflow to the lab’s IT and LIS tools can enable better sample tracking, prevent workflow errors and streamline the process of reporting results.
How to get started: Some manufacturers of automated molecular diagnostics platforms also have integration tools to help labs improve operations. If you’re considering an automated platform, or if you already have one up and running, check with the vendor to see if they can offer or recommend integration tools for your facility’s particular needs.
Standardisation. For truly streamlined operations, molecular labs can implement testing platforms that use the same reagents and other consumables. By standardising on the components labs order most often, teams can reduce per-test costs by taking advantage of economies of scale. This step also minimises training needed in the lab since technicians do not have to learn how to handle different reagents for each platform.
How to get started: Keep reagents and consumables in mind as you evaluate new technologies for the lab, and prioritise those that will work with the products you already keep in stock.
Whether you are actively planning to upgrade your molecular lab or just working to streamline your current workflows, the path to superior performance starts with operational excellence. Consider taking the new Molecular Lab Benchmarking Survey to assess your operations and compare your results with your peers.
