Rethinking Lab Automation

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By Michael Dugan, M.D.

Recently, I read an article explaining how Tesla is changing the paradigm of auto assembly. Henry Ford introduced a linear assembly line which allowed a moving frame and drivetrain to be assembled, followed by key body components and accessories like horns and lights. The entire process was further simplified by Ford's famous quote:

"Any customer can have a car painted any color that he wants so long as it is black."

Tesla is rethinking the basic premise. Much like a modular house, components do not have to be assembled on site. The windows could be assembled in another location. The doors in yet another. So long as these components come together at the right time, the entire assembly works well.  

Nearly all automotive and aviation assembly uses similar processes, however in laboratories, particularly anatomic pathology which is less automated, we may think of the workflow process in a linear fashion. Such ideas are quickly becoming outdated. Today a multi-faceted, multi-component process of assembling a final report is possible.

The key individual components are:  

1. biopsy or sample procedure

2. specimen containment, labeling, stability and transport

3. specimen accessioning

4. specimen gross description

5. specimen processing

6. specimen embedding

7. specimen sectioning and placement on glass slide

8. specimen staining and application of slide coverslip

9. digital imaging or manual microscopy

10. pathologist review [in future with AI assistance]

11. final report

12. follow up with client physician or tumor board, or patient, etc.

The question might be now, how do we build a process that leverages each part to assemble the whole as efficiently as possible?