Laboratory testing is a complex process which involves several steps, from sample extraction to result interpretation. Consequently, conventional laboratory testing is highly labour intensive and susceptible to variability as well as operator error. Errors in laboratory testing result in poor patient outcomes.
As the number of samples processed by laboratories increases, there is also a need to improve productivity. Many tedious processes in molecular diagnostics workflows can be performed by automated equipment such as robotic liquid handling platforms, reducing hands-on time as well as improving accuracy. Bioinformatic software also facilitate standardized reporting and interpretation of laboratory test findings.
In this article, we will explore 5 advantages of automating molecular diagnostics workflows:
Cost savings and improvement in throughput are some of the major reasons to automate molecular diagnostics workflows, especially during outbreaks and pandemics when many samples have to be tested in a short period of time. Conventional laboratory testing is highly labor intensive as several steps are involved at every stage of the workflow. Moreover, technicians can only process a few samples at a time. In high volume testing, this translates to a longer turnaround time to test all samples and higher manpower costs in the long run. As automated systems can process a larger number of samples in the same period of time (e.g. pipetting 384-well plates on a regular basis), the implementation of automation in molecular diagnostics workflows can significantly reduce the number of technicians required, thus saving manpower costs. During a ten year period in which there was a 365% increase in the number of PCR tests performed at the Molecular Diagnostic Laboratory of the Institute of Microbiology of Lausanne, the laboratory staff only increased by 35.9% with the implementation of an robotic liquid handler. It is estimated that salary costs of approximately US $400,000 a year were saved, thanks to automation [1].
Automated liquid handling platforms like the Sentosa® SX101 can also be programmed to perform several processes in the molecular diagnostics workflow. In Vela Diagnostics’ automated workflows, sample extraction, PCR preparation and NGS library preparation are performed on the Sentosa® SX101 using different applications. The ability to perform several procedures on a single platform streamlines processes, thus minimizing the time taken to transition from one procedure to another. For example, the Sentosa® SQ HIV-1 Genotyping Assay performed on the automated Sentosa® next-generation sequencing (NGS) workflow has a significantly reduced hands-on time of less than 2 hours, compared to 17 hours or more for conventional assays which are performed manually [2].
The use of automation to minimize hands-on time and turnaround time is especially crucial during major infectious disease outbreaks such as the COVID-19 pandemic. In these situations, it is vital for physicians and patients to know the results of their tests as soon as possible so that treatment and disease containment measures can be implemented promptly. Using the ViroKey™ SARS-CoV-2 RT-PCR Test, 46 samples from patients suspected of COVID-19 can be processed in 3.5 hours. Thus, effective treatment and measures to contain the disease can start as soon as infected patients have been identified, leading to improved outcomes in patient and community health.
Given its complexity, laboratory testing is prone to human errors. It has been reported that more than half of the errors occur in the pre-analytical stage of laboratory testing in areas such as patient sample identification. As approximately 70% of all medical decisions related to diagnosis and treatment are made based on laboratory tests, there is a critical need to minimize laboratory errors in vulnerable areas. Barcode scanning and other automated systems have significantly reduced human errors such as incorrect data entry and mislabelling of patient samples [3].
Misinterpretation of test results may result in patients not receiving the appropriate treatment [4]. Automated analysis by programs such as the Sentosa® SQ Reporter and the Sentosa® SA Reporter enable standardized and accurate interpretation of molecular diagnostics results, ensuring that patients receive safe and effective treatment.
By enabling high throughput sample processing and standardized result interpretation, automation holds great promise for revolutionizing molecular diagnostics. Given the benefits associated with automating laboratory processes, it is time that laboratories give serious thought to incorporating automation in their day-to-day operations!
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