Section of Clinical Biochemistry, University Hospital of Verona, Piazzale LA Scuro, 37134 Verona, Italy.
Laboratory Medicine, San Bassiano Hospital, Bassano del Grappa, Italy.
Clin Chem Lab Med. 2019 May 27;57(6):802-811. doi: 10.1515/cclm-2018-1323.
Automation is considered one of the most important breakthroughs in the recent history of laboratory diagnostics. In a model of total laboratory automation (TLA), many analyzers performing different types of tests on different sample matrices are physically integrated as modular systems or physically connected by assembly lines. The opportunity to integrate multiple diagnostic specialties to one single track seems effective to improve efficiency, organization, standardization, quality and safety of laboratory testing, whilst also providing a significant return of investment on the long-term and enabling staff requalification. On the other hand, developing a model of TLA also presents some potential problems, mainly represented by higher initial costs, enhanced expenditure for supplies, space requirements and infrastructure constraints, staff overcrowding, increased generation of noise and heat, higher risk of downtime, psychological dependence, critical issues for biospecimen management, disruption of staff trained in specific technologies, along with the risk of transition toward a manufacturer's-driven laboratory. As many ongoing technological innovations coupled with the current scenario, profoundly driven by cost-containment policies, will promote further diffusion of laboratory automation in the foreseeable future, here we provide a personal overview on some potential advantages and limitations of TLA.
自动化被认为是实验室诊断学近期历史上最重要的突破之一。在全实验室自动化（TLA）模式中，许多在不同样本基质上执行不同类型测试的分析仪被物理集成作为模块化系统，或者通过装配线物理连接。将多个诊断专业整合到一个单一轨道的机会似乎可以有效地提高实验室检测的效率、组织、标准化、质量和安全性，同时也能在长期内获得显著的投资回报，并使员工能够重新获得资格。另一方面，开发 TLA 模式也存在一些潜在的问题，主要表现为初始成本较高、耗材支出增加、空间要求和基础设施限制、人员拥挤、噪音和热量增加、停机风险增加、心理依赖、生物样本管理的关键问题、特定技术培训人员的工作中断，以及向制造商驱动的实验室过渡的风险。由于许多正在进行的技术创新以及当前受到成本控制政策驱动的情况，将在可预见的未来促进实验室自动化的进一步普及，因此，我们在这里对 TLA 的一些潜在优势和局限性进行个人综述。
