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Miswar Fattah, M.SiMakassar, 6 Juni 1978

1997 : SMAK Depkes Makassar 2002 : Chemistry - University of Hasanuddin2006 : Clinical Chemistry, Biomedic- University of Hasanuddin

Research & Esoteric laboratory Head, Prodia Clinical LaboratoryMolecular Diagnostic Scientist, R&D Prodia Clinical LaboratoryScientific division of Molecular Diagnostic , Indonesian Association for Clinical ChemistryInternational Relationship departemen PATELKI

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Miswar Fattah, Msi

TOT

Bandung , 27 November 2011

PATELKI

Term of automation

Concept automation in clinical laboratory medicine : a history

Current concept in automation of laboratory medicine

Impact automation in medical technologist & Regulation

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Automation is the use of control systems and information technologies to reduce the need for human work in the production of goods and

services

Laboratory automation is the use of instrument and specimen processing equipment to perform clinical

assay with only minimal involvement the technologist

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Reduce human error Safety decrease laboratory costs improve turnaround time increase productivity Run more tests  Test in fewer sites Operate with fewer instruments.  Retain lower operating costs.  Employ relatively less skilled labor.  Use more automation in a paperless

environment

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Lab Test• Faster TOT• Accuracy,

Precision, Safety Add information

value• Autovalidation• Trending

Effecting change using lab results• Lifestyle changes• Selection of

therapeutics

Lab TestAutovalidation

TrendingLife Style Adjustments

Appropriate Therapeutics

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In the early years of clinical laboratory science--the 1920s, 1930s, and 1940s--tests and assays were performed manually

 evolution of clinical laboratory automation began in the late 1950s with the development of flame photometry and peripheral blood cell analysis

PATELKIClin Chem 1958;4:127– 41

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the Coulter Counter in 1957 revolutionized the counting of a variety of peripheral blood cells, including red blood cells and leukocytes

Wallace H Coulter

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Technicon Autoanalyzer II (AAII) systemPeristaltic Pump Module

AutoAnalyzer is an automated analyzer using a special flow technique named "continuous flow analysis (CFA)" first made by the Technicon Corporation. The instrument was invented 1957 by Leonard Skeggs, PhD and commercialized by Jack Whitehead's Technicon Corporation. The first applications were for clinical analysis, but methods for industrial analysis soon followed.

PATELKI ClinChem 1964;10:918 –36

The first multichannel analyzer to perform eight determinations simultaneously is described. The analyzer records directly oncalibrated paper, providing an “immediately usable form”. One operator can perform 960 individual tests per day, equal to the output expected per person in a month with manual techniques

PATELKI Clin Chem 1966;12:120 –36

Multichannelanalyzers allow 10 simultaneous determinationson 1 mL of serum at a rate of 60 specimens perhour

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First fully automated in clinical laboratory implement in Kochi Medical School by Masahide Sasaki (Automation Pioneer ). Modular system

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Robotik / mekanik Fluidic Metode Track Sensor Komputer Software Barcode

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gantry robot

The SCARA (Selective Compliance Assembly Robot Arm)

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Continuous Flow Analyzer•Tubing flow of reagents and patients

samples

Flow Injection Analyzer•Centrifuge force to mix sample and reagents

Dialyzer module•Separate testing cuvets for each test and

sample•Random and/or irregular access

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In continuous flow analyzers, •samples were aspirated into tubing

to introduce samples into a sample holder,

•bring in reagent, •create a chemical reaction, •and then pump the chromagen

solution into a flow-through cuvette for spectrophotometric analysis.

CONTINUOUS FLOW

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• The major drawbacks that contributed to the eventual demise of traditional continuous-flow analyzers in the marketplace were significant carry-over problems and wasteful use of continuously flowing reagents.

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Continuous flow is also used in some spectrophotometric instruments in which the chemical reaction occurs in one reaction channel and then is rinsed out and reused for the next sample, which may be an entirely different chemical reaction.

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Discrete aliquots of specimens and reagents are pipetted into discrete chambers in a rotor

The specimens are subsequently analyzed in parallel by spinning the rotor and using the resultant centrifugal force to simultaneously transfer and mix aliquots of specimens and reagents into radially located cuvets.

The rotary motion is then used to move the cuvets through the optical path of an optical system

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Discrete analysis is the separation of each sample and accompanying reagents in a separate container.

Discrete analyzers have the capability of running multiple tests on one sample at a time or multiple samples one test at a time.

They are the most popular and versatile analyzers and have almost completely replaced continuous-flow and centrifugal analyzers.

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Sample reactions are kept discrete through the use of separate reaction cuvettes, cells, slides, or wells that are disposed of following chemical analysis.

This keeps sample and reaction carryover to a minimum but increases the cost per test due to disposable products.

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Fluorescence Detection Technologies• Fluorescence Intensity (FLINT)

• Fluorescence Polarization (FP)

• Fluorescence Correlation Spectroscopy (FCS)

• Fluorescence Resonance Energy Transfer (FRET)

• Dissociation-enhanced lanthanide fluoroimmunoassay (DELFIA)

• Homogenous Time Resolved Fluorescence (HTRF)

• LANCE Ultra™

• Fluorescence Lifetime Analysis (FLA) Luminescence Detection Technologies

• Glow Luminescence

• Flash Luminescence

• AlphaScreen™

• Electrochemiluminescence (ECL)

• Bioluminescence Resonance Energy Transfer (BRET) Radiometric Detection Technologies

• Filter Binding Assays

• Scintillation Proximity Assays (SPA)

• FlashPlates®

• LEADseeker™

Absorbance Detection Technologies Other Technologies

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  Laboratory use• Identification of sample-containing vessels: • Identification of reagent-containing vessels:• Identification of equipment:• Identification of laboratory personnel:• Entry of instructions or data:

Technology• bar codes, • Radio Frequency Identification (RFID), • biometrics, • magnetic stripes, • Optical Character Recognition (OCR), • smart cards, and voice recognition.

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Paramagnetic microparticle capture and detection

Reagent lot numbers are automatically linked to results

Bar codes of randomly loaded samples are read

Tubes are sampled through pierceable caps

Overview

Pictures and video from Gen-Probe

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Sneaker net Mobile robotics Conveyor belt Accelerated conveyor belt

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Mobile Robot Conveyance

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Ball and Socket Closure Device

The Lasette (Cell Robotics, Albuquerque)

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Bar coding at the point-of-phlebotomy

2D vs. 1D bar codes• Reduce the number of

computer interfaces• Self directing

specimens RFID

• Current costs of RFID around 25 cents

B-D id

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Phlebotomy Tray Preparation

BC-ROBO – mini 20Single tray system

BC-ROBO – mini 40Multi-tray system

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Hematologi Kimia klinik Immunologi Analisa berbasis sel Mikrobiologi Molekular diagnostik dll

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Picture of the UVA labhere

Sonic HealthcareSydney Australia

The University of VirginiaClinical LaboratoryCharlottesville, VA

Conveyor Distribution Technologist Distribution

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Automated work cell

Automated workstationcapable of performing a limited set of Laboratory Unit Operations (LUO's) (as few as two) in an automated mode, coordinated by a workstation controlle

A special case of an integrated system.  Preconfigured, often available commercially off-the-shelf as a standard system for a given type of or class of sample processing

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Leonard T. Skeggs

PATELKI 38BIOPHILE,Inc., Charlottesville, VAIDS, Japan

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 bioMerieux’s PREVI Isola is a system for automating routine agar plate inoculation. It maximizes colony isolation, eliminates risks, and standardizes plate inoculation and results in a fully automated approach

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Health Intervention

Smart House Monitoring

Data Interpretation

Early Warning of Disease Onset

Genomic Screen for Chronic Disease

Personal Health Improvement

Proteomic Assessment

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In vivo Cytometry-A Next Generation Diagnostic Tool. A Real-time health monitoring

flow cytometry is a method of counting thousands of cells per second

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· AUTO1—Specimen Container/Specimen Carrier contains standards for the design and manufacture of specimen containers and carriers used for collecting and processing samples, such as blood and urine, for testing on laboratory automation systems.

· AUTO2—Bar Codes for Specimen Container Identification provides specifications for linear barcodes on specimen containers for use on laboratory automation systems.

· AUTO3—Communications with Automated Systems facilitates accurate and timely electronic exchange of data and information among automated instruments, laboratory automation systems, and other information systems.

· AUTO4—Systems Operational Requirements, Characteristics, and Informational Elements provides standards of interest to operators for display of system status information such as specimen location, reagent supply, and warnings and alerts to support laboratory automation operations.

· AUTO5—Electromechanical Interfaces provides guidance for the standardization of electromechanical interfaces between instruments and/or specimen processing and handling devices and automation systems in the automated laboratory.

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Automation of the main chemistry analyzers, including immunoassay and linking them together with preanalytical and postanalytical automation to give total laboratory automation has given predictability to result availability