Clinical laboratory automation: concepts and designs.

Compared with other industries, automation in the healthcare arena has been slow to evolve. Changes in reimbursement for services provided are forcing hospitals and other healthcare providers to look for more cost effective mechanisms to provide all forms of health related services. Clinical laboratory services are essential to the support of hospital operations and most clinic operations. The current paradigm for clinical laboratory operations is based upon a mix of both batch and random access testing and is highly dependent upon clinical laboratory personnel. Changes in the paradigm for clinical laboratory operations may result in a significant cost savings when fully implemented while maintaining a high level of quality and service for the patients. Several different laboratory organization structures are discussed. The Nebraska automation project is described including the development of a modular conveyor system, the use of automated guided vehicles, software, and network architectures. Future directions for the development of clinical laboratory operations including the creation of a "docking device" to link automation systems to instruments is proposed.