S. RAYMOND GAMBINO, M.D. This article was reprinted by permission from Transactions of the New York Academy of Sciences, Vol 32, No. 8, S.R. Gambino. © The New York Academy of Sciences; 1971
TN THIS PAPER I attempt to define
••-the met and unmet needs of the automated clinical laboratory to aid in guiding the decisions made by designers, manufacturers, and users. Unless the automated clinical laboratory is developed as a total system we will create pockets of success and pools of chaos (1). What do I mean? If, for example, we continue our logarithmic success in automating ordering, analysis, and reporting of tests, but at the same time do little about automating collection, transportation, identification, separation, evaluation, and required action, we will have the kind of success cum chaos that we have in our nationwide transportation system.
College of Physicians & Surgeons, Columbia University, 630 West 168th St., New York, N.Y. 10032
If our automated laboratory is capable of spewing out 6000 test results per hour, but we have no efficient system for interpreting, sifting, cataloging, and acting upon this data, we will then have the same kind of problem one gets when a mechanized parking lot discharges more cars per minute than the street can handle.
Met and Unmet Needs of the Automated Clinical Laboratory What is Available?
When lab tests are performed on patients, the following procedures are carried out: ordering, collection, transport, identification, separation, analysis, reporting, evaluation, and action. Most of these steps are not automated. However, they must be automated or be eliminated. One way to eliminate them is to make it possible for the physician (and eventually for the patient himself) to obtain his own laboratory data. Direct operation by the physi-
Development of the automated clinical laboratory should proceed by considering the total system from the ordering to the evaluating of laboratory tests
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REPORT FOR ANALYTICAL CHEMISTS cian is t h e concept underlying t h e design of the Instrumentation L a b oratory, I n c . (Lexington, Mass.) Model 313 Blood Gas Analyzer. T h e Model 313 h a s a simple push-button control panel. When the operator presses " C a l i b r a t e " the instrument is washed with a heparinized cleaning solution equili brated with oxygen a n d carbon di oxide. Automatic timing circuits control t h e movement of specially designed, gas-tight rotary valves t h a t switch from flushing solution to gas. Indicating circuits a r e kept locked until a n equilibration period has passed a n d a data light indicates it is appropriate to eval u a t e t h e calibration data. λΥηοη t h e operator presses " S a m p l e " the instrument automati cally pumps t h e blood sample through a preheater, into t h e microchamber
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IDee system for positive sample identi fication eliminates the danger of mis matching samples and results in the laboratory. The system consists of a 40-position sampler that will accommo date either Vacutainers or sample cups, and the optical and electronic equip ment necessary to read a coded label, recognize the coding, store the informa tion until test results are available, and print the correct decoded decimal rep resentation on chart paper. The IDee is designed for use with the SMA 1 2 / 6 0 and SMA 6 / 6 0 systems
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