Total Laboratory Automation and Diagnostic Immunology

" The first rule is that a robot may not allow. .. a human to come to harm. " Isaac Asimov (2) A Two-Person Conversation in a Fugue State GATES: What a great era: computers, microchips, browsers, automation , and worldwide windows. FEYNMAN: Don't forget quantum physics. Don't forget rubber gaskets. Don't forget bongo drums. GATES: Quantum physics helps us develop computer networks but gaskets and bongo drums? This is difficult, very difficult, maybe even macrodifficult to understand. FEYNMAN: Inferior rubber gaskets and greed led to the Challenger tragedy. GATES: What's your point? FEYNMAN: Untested technology, as sophisticated as it may appear in planning, is still untested. Each system needs to be validated. Human invention and intervention is needed to prime and maintain progress. GATES: We agree on something. A great idea, from whatever source, is not useful until it is tested and validated. But bongo drums. .. FEYNMAN: Have some fun along the way. The number of total laboratory automation (TLA) installations is growing but TLA has only begun to impact diagnostic immunology. I will use the terms integrated laboratory automation , laboratory automation system, and TLA interchangeably in this commentary. TLA is intended to be a system of laboratory instruments under a unified control that requires little or no human intervention at any stage of the process. The process may include drawing blood, reporting the result, and discarding or saving the sample. Automation is old stuff in clinical laboratories: the speed, quality, and diversity of instruments designed to perform testing on blood and urine samples have continued to improve since the end of World War II. These instruments first mimicked manual methods but later took advantage of newer technologies. First clinical chemistry and then hematology were impacted by these instruments, which allowed laboratories to meet the large increase in testing demand without adding greatly to the number of staff and costs. If anything, the cost per test was reduced. But clinical laboratories remained cottage industries with each section, such as chemistry, microbiology , hematology, and immunology, doing its own thing and having its own management and performance and quality rules. There was little interdisciplinary cooperation (5). Dr. Masahide Sasaki in Kochi, Japan, in the 1980s created the first and a most dramatic example of an integrated and automated laboratory. Dr. Sasaki used existing analytic instru-mentation but rearranged their physical positioning in the laboratory and developed conveyance and robotic …