In my mind, three functional domains for lab testing in hospitals have evolved over time. First is the core lab which is optimized for highly automated, routine lab tests, primarily in chemistry and hematology. Second are the specialized and esoteric labs like molecular pathology and the blood bank that are less automated. Third is point-of-care (POC) and STAT/emergency testing with tests performed in decentralized locations rapidly using smaller devices. A recent article from the Dark Report noted that the IVD companies are expanding the menu of tests available on their new, automated platforms (see: Top-5 Diagnostics Trends Identified by Kalorama Will Impact In Vitro Diagnostics Manufacturers, Medical Laboratories in 2017). Below is an excerpt from it:
As healthcare organizations consolidate, IVD companies are looking at core lab markets and automation systems that target big accounts....Two examples of such IVD companies are Abbott Laboratories ...and Siemens Healthineers. Abbott...issued a statement announcing a new diagnostic platform for clinical laboratories, clinicians, and medical institutions called Alinity. It’s a “harmonized” platform of immunoassay, clinical chemistry, point-of-care, hematology, blood and plasma screening, and molecular diagnostics systems. Siemens Healthineers also introduced a new solution to automate core lab testing call Atellica. This is an immunoassay/clinical chemistry solution with patented bi-directional magnetic sample-transport technology that, according to the press release, is 10 times faster than conventional conveyors, is scalable across configurations and locations, and enables simplification of lab operations, streamlined inventory control, and consistent testing results.
This sentence about describing the functionality of the Alinity platform was instructive: a “harmonized” platform of immunoassay, clinical chemistry, point-of-care, hematology, blood and plasma screening, and molecular diagnostics systems. If many lab professionals had their way, there would probably be fewer POC tests available. These tests are more expensive than those in the central labs and are often performed by non-lab professionals. The quote above does not exactly make sense in that point-of-care tests, by definition, cannot be performed in a core lab which is usually distant from patient care sites. However, I think that the claim is being made that the Alinity platform offers flexibility and rapid turn-around-times that are comparable to tests performed on smaller instruments in distributed locations closer to patients.
If the claims being made for the Alinity and Atellica platforms are correct, it may be possible in the near future to reduce POC testing when and where rapid delivery of specimens to the core lab is possible and the lab can be run on a 24-hour basis. Test results, of course, will appear in the EHR database immediately after test completion. I don't think that such a plan would be unacceptable to clinicians if the test TAT is rapid. Of course, patient care sites far removed from the core lab would need to continue to perform STAT or urgent lab tests using POC instruments.