As licensed health care workers are in shorter supply, intelligent machines are handling more of the workload.
An example: the automated laboratory system at Memorial Medical Center in Modesto.
Since going live in March, the system has become a workhorse for running tests for patients at Memorial and the clinics of the Sutter Gould Medical Foundation in Stanislaus and San Joaquin counties.
It's running 788 tests on blood and urine samples per hour, from cholesterol checks to tests to determine whether a patient in the emergency room has suffered a heart attack.
"It is nice not having to cap the tubes all the day long," said Matt Wilson, a clinical laboratory scientist at Memorial. "It frees me up to take care of other problems."
The machine isn't replacing people like Wilson; rather, it's filling a void created by a national shortage of clinical lab scientists.
The federal Bureau of Labor Statistics projects a nationwide need for 138,000 medical lab technicians by 2012, but training programs are producing only 5,000 graduates a year. The field has suffered from sluggish wage growth and a lack of career development opportunities, says the Center for California Workforce Studies at the University of California at San Francisco.
Memorial, which is affiliated with Sacramento-based Sutter Health, acquired the automated lab system as it streamlined lab operations with the Sutter Gould Medical Foundation. With the new system, it's able to process many of the blood and urine samples collected at the Sutter Gould medical offices, without a significant increase in personnel costs.
It ran close to 140,000 chemistry tests in March, compared with 80,000 per month last year when lab personnel were processing the tests manually.
"I hired only one unlicensed employee to remove specimens for us," said Danny Arim- boanga, regional laboratory services director for Sutter Health's Central Valley service area. "It certainly gave us the ability to take on more volume."
The equipment is used for routine tests such as blood chemistry panels, while the lab scientists work on bacterial cultures and more sophisticated tests. The equipment can do hepatitis, human immunodeficiency virus and drug testing.
It cost $1 million to purchase the Italian-made StreamLab Chemistry Automation technol- ogy and remodel the lab, Arimboanga said. Only one other Sutter hospital in California has the technology. Memorial officials expect that the system will pay for itself in four years.
Put tubes in, let system do rest
The system has automated tasks that once were done manually by laboratory staff. It's especially useful in preparing the specimens for analysis, Arimboanga said.
The equipment combines technology, including robotic arms, electric eyes, infrared scanners and computerized analyzers.
Lab workers place the tubes in the racks and the equipment does the rest. It spins the blood samples to separate the plasma, uncaps the tube, takes a specimen from the plasma, recaps the tube, runs the analysis, and then returns the tube to the racks.
The results are reported to physician and patient through an electronic records system. The equipment keeps track of the tubes in case another test is needed.
Arimboanga said the system enables the lab to offer more reliable turnaround times for tests. Lab workers handle fewer samples, so there is a lower risk of infection with hepatitis C or HIV.
With the StreamLab completing 788 tests per hour, some may question how it knows which tube belongs to which patient.
Each time a patient gives a fluid sample at the hospital or a clinic, a sticker with the patient's name and birthdate is put on the tube. The sticker also has a bar code, which is read by the automated equipment.
To ensure that the equipment is providing accurate results, quality control assessments are done every 24 hours, Arimbo- anga said. So far, there have been no major glitches, he said.
The lab participates in the College of American Pathologists monitoring program. Two or three times a year, the professional organization sends blind samples to participating labs to measure reliability.
Modesto resident Carol Hartman, who has been a Memorial patient, said last week she wasn't aware that a machine was handling the lab work. She noted that people make mistakes and there is always opportunity for human error in operating equipment.
"I would want to thoroughly check it out before having any major tests done," she said. "I would expect they would be very thorough and make sure the quality control is there."
Joan Polancic, education director for the American Society of Clinical Laboratory Science, said the testing processes in clinical labs have been automated for years. What's new is the hardware for the front-end handling of specimens. Commercial labs started using it about five years ago, and now it's being incorporated by the larger hospital labs, she said.
Proponents of automation say the systems reduce errors that can occur during the handling of specimens or when specimens sit too long before testing.
"We haven't had any negative reports about these systems," Polancic said.
Machinery set up for add-ons
Arimboanga said the equipment was set up so more hardware can be added. The goal is to support patient growth in Sutter's service area that includes Memorial, Sutter Gould, Memorial Hospital Los Banos and Sutter Tracy Community Hospital.
Memorial collaborates with the University of California at Davis in a training program for licensing clinical lab scientists. The program requires a bachelor of science degree and completion of the one-year lab sciences training.
Bee staff writer Ken Carlson can be reached at firstname.lastname@example.org or 578-2321.