Modern clinical laboratories often face significant operational pressure. On one hand, there remains an acute shortage of clinical laboratory professionals throughout the United States. While the issue worsened as a result of the COVID-19 pandemic, the origins of the shortfall can be traced back multiple decades, and there’s no sign it will improve soon. The number of individuals graduating from specialist training programs is not keeping pace with rising demand, and a significant cohort of the current laboratory workforce is approaching retirement age.
In parallel, demands for testing throughput and turnaround times (TATs) continue to increase. Labs regularly process thousands of tests a day while managing all the additional tasks that come with instrument calibration, maintenance, and the overall operation of a CLIA-certified laboratory.
Looking toward a five-to-10-year horizon, market projections indicate that elevated testing volumes and personnel shortages will continue to challenge the industry. To mitigate these systemic pressures, a commitment to technological innovation remains critical for operational success. Automation and increased throughput will be critical pillars in this evolution. However, resilience requires more than simply increasing instrument speed or adding capacity. Systems need to reduce the hands-on burden that laboratory professionals currently manage while minimizing day-to-day workflow bottlenecks. Technical specifications are informative, but real-world integration and throughput capacity within active laboratory workflows remain the definitive metrics for adoption.
High-volume testing and increasing throughput
High-throughput automation remains foundational for laboratories managing large and growing sample volumes, particularly in settings where speed and consistency directly influence patient care. Large hospital labs, for example, rely on automated clinical chemistry and immunoassay systems to run hundreds or even thousands of tests per hour across applications such as comprehensive metabolic panels, lipid panels, cardiac markers, and endocrine assays. This level of performance is critical for supporting rapid TATs in acute care settings, from emergency department electrolyte testing to time-sensitive markers such as troponin. Newer platforms can deliver on that throughput, with capacities reaching up to 2,000 tests per hour with expanded reagent availability. The systems are designed for efficiency, unlocking continuous, random-access sample flow and reducing delays caused by repeat or reflex testing.
While important, in the real world, throughput alone is not a silver bullet. Laboratories that focus exclusively on speed risk accruing bottlenecks elsewhere in their workflows. This is why the most effective automation strategies balance high performance with thoughtful system integration. With this approach, gains in analytical speed can translate into meaningful reductions in total TAT and more reliable, end-to-end efficiency.
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Easing the calibration and maintenance burden
When it comes to overall efficiency, a significant portion of a lab’s operational burden comes from routine maintenance and calibration tasks that quietly consume time and attention throughout the day. These activities are essential for ensuring accuracy and reliability, but they are repetitive and time-intensive. The tedious nature of maintenance and calibration can detract from more meaningful work, thereby contributing to staff burnout and preventing the lab from advancing in other areas of the business.
Recent advances in instrument design are beginning to address this hidden labor directly. With newer systems, many maintenance functions can now be performed automatically and in the background. For labs, the advances can be significant, potentially reducing the need for operator intervention from daily to monthly. One example is the integration of an advanced ultrasound technology to automatically clean sample probes after a designated number of pipetting cycles. This eliminates the need for standard daily pipette maintenance at the start or end of a shift, or during scheduled downtime.
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Instrument calibration is another area where incremental improvements can help relieve some of the pressures modern clinical laboratories face. In high-volume laboratories running a wide range of assays, calibration events may need to occur dozens of times per day. While each calibration session may take only 10 to 20 minutes, the total time commitment quickly adds up. And once again, this background task diverts skilled team members from more complex or additive work. By eliminating the need for manual calibration of reagent lots and improving lot-to-lot stability, newer systems significantly reduce the frequency of required calibration events. The result is not only a measurable reduction in hands-on time but also a more consistent, predictable workflow.
Decoupling ISE testing
For many years, advances in clinical laboratory technology have focused on integration—bringing systems together for ease and efficiency. However, there are exceptions and scenarios in which a standalone unit can offer greater flexibility. This is the case with ion-selective electrode (ISE) testing for electrolytes such as sodium, potassium, and chloride.
Electrolyte testing is typically performed alongside clinical chemistry and immunoassays on a single, integrated platform. The challenge is that any downtime, calibration, or maintenance needed for the ISE module can impact throughput and availability across the integrated unit (and vice versa). Electrolyte testing is often high-volume and time-sensitive, helping healthcare providers triage, for example, renal failure or metabolic crises in an emergency department setting. As a result, significant ISE module downtime and subsequent delays can introduce risks for patient care.
With this complex interdependency in mind, some newer instruments are decoupling the ISE component, allowing electrolyte testing to run in parallel and continue operations even if the core chemistry unit is offline. While they’re still spatially compatible, the ISE modules are designed with a standalone water, power, and basic solution supply, allowing maintenance to be performed independently. At a time when laboratories are under pressure to do more with fewer resources, this example of decoupling systems is an interesting shift in analytical chemistry, addressing real-world workflow challenges.
Considerations for smaller labs
Evaluating the benefits of automation and new technology is an exercise that looks different in smaller labs, which operate at an entirely different scale. For high-throughput labs, the goal is typically marginal gains across thousands of samples. For smaller labs, the benefits are more closely tied to consistency and the ability to multitask. Automation allows a lean team of technicians to walk away from the bench to perform analysis or client outreach while the instruments handle the prep, maintenance, or calibration. Automated, operator-independent technologies provide vital operational continuity during periods of personnel turnover or prolonged recruitment challenges. By decoupling workflow execution from manual intervention, these platforms serve as an important mechanism for analytical standardization and stability.
Even the best technology fails if the transition is poorly managed. For this reason, it’s important to anticipate potential points of friction. For example, labs should ensure the new technology integrates with existing laboratory information management systems (LIMS) to avoid manual data transfers and data siloes that can occur if the output is in a proprietary format.
It’s also important to recognize that success and gains in productivity won’t happen overnight. For starters, the validation requirements in clinical labs and new documentation can take as long as the installation itself. And then there is often a temporary dip in productivity during the training phase. The consequences of this can be mitigated to some extent by planning new instrument installations during lower-volume periods.
Finally, in our modern era, new technologies may encounter some resistance from staff who fear that the automation may replace their jobs. Lab management must be sensitive to staff concerns, showing support and assuring technicians that their jobs are secure. For example, by focusing on what the technicians gain and the higher-level, higher-value activities they can do with the time savings.
The first step is looking inwards
To build resilience in a clinical laboratory in the face of today’s challenges, lab leaders need to embrace technologies that meet throughput needs while reducing the overall manual burden of running tests. In practice, this looks different in every setting, so labs should start the process by identifying what success looks like for them. The value of automation should be measured not only in throughput, but also in reclaimed staff capacity. Metrics such as reductions in manual maintenance touchpoints, fewer calibration interventions, decreased overtime hours, and improved turnaround time consistency can help laboratories quantify operational improvements.
By reducing time spent on routine operational tasks and minimizing points of friction in the workflow, these innovations free laboratory professionals to focus on higher-value activities that directly impact patient care. This is the kind of innovation needed to drive labs forward in competitive and sometimes resource-constrained environments.
