Ortho Clinical Diagnostics is a global leader of in vitro diagnostics serving the global clinical laboratory and immunohematology communities. Across hospitals, hospital networks, blood banks, and labs in more than 120 countries, Ortho’s high-quality products and services enable healthcare professionals to make better-informed treatment decisions. For the immunohematology community, Ortho’s blood typing products help ensure every patient receives blood that is safe, the right type and the right unit. Ortho brings sophisticated testing technologies, automation, information management, and interpretation tools to clinical laboratories around the world to help them run more efficiently, effectively and improve patient care. Ortho’s purpose is to improve and save lives with diagnostics and it does that by reimagining what’s possible. This is what has defined Ortho for more than 75 years, and it’s what drives Ortho forward. For more information, visit www.orthoclinicaldiagnostics.com.

Medanta improves efficiency and performance with Ortho Clinical Diagnostics VITROS® Automation Solutions

Medanta “The Medicity” is one of India’s largest and most prestigious multi-specialty medical institutions. Medanta is one of the largest cardiac centers in the private sector, attracting patients from all over the world.

Customer at-a-glance

  • Medanta supports 1,250 patient beds, and 350+ critical care beds.
  • Operating around-the-clock (24/7), the core laboratory is staffed by 3 physicians and 13 technicians.
  • On average, the core lab processes:

– Between 50,000-60,000 sample tubes per month.
– 2,000-2,500 patient samples every day.
– About 4 million chemistry tests and 300,000 immunoassay tests per year.
– A large variety of testing parameters (routine chemistry, immunoassay, HPLC, electrophoresis, therapeutic drug monitoring).

  • For clinical chemistry testing, the lab relies on two VITROS® 5600 Integrated System analyzers, and one VITROS® 5,1 FS Chemistry System.
  • Medanta implemented VITROS® Automation Solutions in early 2016, becoming the first installation globally for Ortho.

The challenge
In 2015, Medanta’s core laboratory was facing tremendous pressure to increase productivity, contain costs and improve quality and service. Like many laboratories, its testing volume was on the rise, laboratory workload was growing, and technologists were spending too much time on non-valueadded steps in the testing processes. Over time, this led to workflow inefficiencies, an increase in reporting errors and longer turnaround time (TAT), which affected the laboratory’s ability to deliver timely, accurate results to physicians.

Straining under the weight of the manual workload, the lab decided to pursue a total laboratory automation solution in order to achieve several important goals:

  • Realize greater workflow productivity and overall lab performance
  • Improve turnaround time (TAT) for faster delivery of results and quicker clinical decision-making for patients
  • Increase the quality of test results and reduce errors
  • Accommodate an increasing workload
  • Enhance clinical value and physician satisfaction
  • Deliver a best-in-class patient care experience

VITROS® Automation Solutions
In February 2016, seeking to streamline its testing process and drive efficiency, Medanta moved from using multiple standalone analyzers to a total laboratory automation system built with Ortho VITROS® Automation Solutions. Before VAS implementation, they were using three analysers and with help of ValuMetrix™ team, Medanta could able to install six analysers in the same space. The solution automated the laboratory’s multiple VITROS® Systems, and most of the laboratory’s manual sample processing steps.

Today, VITROS® Automation Solutions automate Medanta’s entire sample handling and testing process for chemistry and immunoassay testing, including intelligent routing of samples, reflex testing, repeat testing and data management to minimize physician inquiries, staff interventions and manual rework.

The results
Improved labor efficiency and safety: With VITROS® Automation Solutions, Medanta streamlined the entire preanalytical and post-analytical testing process, eliminating manual tasks and freeing up skilled labor for tasks that truly require operator intervention. The new solution also automatically balances workloads and eliminates workstation bottlenecks, while reducing lab technologists’ exposure to biohazards. In addition, results-based routing handles re-runs, dilutions and reflex testing without operator intervention, while VITROS® dry slide technologies reduce the need for unplanned maintenance.

VITROS® AUTOMATION SOLUTIONS IN MEDANTA’S LAB.

Fewer sample rejections: The lab’s steady monthly decline in sample rejection rate from 0.5% in January 2016 (the month before TLA implementation) to 0.21% in April 2016 demonstrates the automation system’s impact on reducing errors. This noticeable decrease occurred despite the ongoing increase in the number of sample processed (from 53,000 in January to 59,000 in April).

A better comparison of the impact of automation using the sample rejection rate is a comparison between November 2015 and June 2016. Despite both months having nearly same number of analyzed samples (around 51,000), there were 241 rejected samples in November 2015, compared to 143 rejected samples in June 2016—a decrease of 41%. 

Comparison of the impact of automation with data provided by Medanta to Ortho under contract; covering November 2015 to June 2016. Data on file. 

Faster turnaround time: As a hospital-based laboratory, Medanta’s core lab knows the value of fast turnaround time—especially for urgent samples. Before implementing automation, however, it was struggling to deliver test results within its expected 2 hours. For many tests, the turnaround time was high, and the lab was receiving a lot of pressure from clinicians to deliver reports more quickly. In August 2016 (after using total lab automation for several months), Medanta’s core lab was achieving an average in laboratory TAT of 20 minutes—a significant reduction from just four months before, when its average TAT was 148 minutes (in April 2016). The lab’s average TAT for clinical chemistry continues to reduce as personnel gets more adept at using the system. The continuous training support from Ortho has really helped the technicians reduce TAT.

Turnaround Time Comparison with data provided by Medanta to Ortho under contract; covering April 2016 to August 2016. Data on file.

FIGURE 1: TAT COMPLIANCE FOR ROUTINE SAMPLES — BIOCHEMISTRY
TAT Compliance for Routine Samples- Biochemistry with data provided by Medanta to Ortho under contract; covering January 2016 to June 2016. Data on file.

Figure 1 shows that more than 90% of high demand tests are released on time to help enable timely medical decisions to all in and out patients.

Fewer manual process steps: Together, the track modules provide one location point for sample entry and exit, sample sorting and tracking, decapping a variety of primary tubes (at a rate of 600 tubes per hour), and recapping of all sample tubes (at a rate of 500 tubes per hour). The VITROS® Automation Solution also interfaces with Medanta’s laboratory information system (LIS) to streamline data management.

Reduction in errors: By reducing manual, non-valueadded activities in the pre-analytical and post-analytical processes—including sample sorting, decapping, recapping and manual loading—total lab automation has helped the lab reduce human error and also gives technicians more time to monitor quality control. In the event of a QC failure, testing will automatically stop on that specific analyzer immediately, which prevents erroneous reports from being released. With automation, the lab has witnessed a marked decrease in rejected samples.

Enhanced data management: VITROS® Automation Solutions middleware is communicating with the LIS to reduce human errors through automatic handling of value data coming from VITROS® Systems.

Through a preset set of rules, it intelligently and dynamically routes samples to minimize sample travel using VITROS® inventory data, QC and calibration results to bypass a system when a test is not active. VITROS® Automation Solutions middleware automatically reroutes samples for dilution and repeats using analyzers’ results and flags.

Finally, patient’s results autoverification is achieved using quality results data secured by Microsensor technology (Hemolysis, Icterus and turbidity index automatically evaluated for both clinical chemistry and immunoassay tests) and Intellicheck (real time process control of all assay processing steps.)

Improved patient care: Medanta’s implementation of total lab automation has led to a reduced TAT and improved lab productivity, which is improving the brand value of the hospital, increasing revenue and savings by helping to reduce the average length of the stay for patients, and ultimately, improving patient care standards.

For more information, contact your sales representative. Visit our website: www.orthoclinicaldiagnostics.com.

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