Hands-Free Microbiology: Empowering your laboratory with automation and artificial intelligence solutions

Microbiology labs today are challenged to achieve more with fewer resources. Flexible automation solutions effectively address these challenges, reducing the manual workload required for sample processing and turnaround times. Today's webinar provides the opportunity to see total lab automation [00:01:30] and practice and hear from our four microbiology lab leaders who have successfully integrated this technology to meet their unique lab needs. Today we'll identify key features of TLA, determine the benefits and unexpected challenges of TLA implementation, and have a live Q&A with the speakers and technical experts. Please feel free to ask any questions for the Q&A session at any time during the webinar. You can submit your question at the speech bubble icon to the right of your screen. Before I hand over to our speakers for today's presentation, let's see automation in action.

Copan's liquid-based microbiology approach transforms challenging samples for easy [00:03:30] automation. Users can also process non-liquid samples using a streak-only setting. SmartScan technology reads the label and queries the LAS verifying the processing protocol. After an optional vortex step the sample is decapped using a one, 10 or thirty-microliter loop, the sample is inoculated and streaked using classic streak patterns or a lab customized pattern. The loop is checked for accuracy and integrity before each plate and sterilized [00:04:00] after inoculation. Each reusable loop can be used for thirty-thousand streaks, lowering consumable and disposal costs. The flexible loop inoculation system delivers a one-microliter inoculum for urine samples as recommended in the ASM manual of clinical microbiology and other reference standards. After plate inoculation, the plate is barcode labeled. WASP is a modular system that allows labs to customize and meet the unique needs of their lab.

[00:04:30] Using precise state-of-the-art technology to reliably and safely interact with laboratory technologists, collaborative robot reduces manual work and eliminates transcription and transposition errors, which sometimes occur during common laboratory tasks. Plates travel via conveyor from front-end processing to automatic incubation, digital imaging, and automatic interpretation. Using the manual loading carousel, laboratories may streak culture plates offline [00:05:00] and then automate image acquisition and incubation. For bacterial growth interpretation, Copan's dynamic HD imaging for microbiology uses the highest quality image in the industry for the most accurate view of the plate. The system captures a high-resolution time-zero image of each plate as it enters the incubator. The software compares this to later images to identify changes alerting the user of new growth.

The efficient dual robot system places plates on individual shelves [00:05:30] in smart incubators, plates may be inverted to prevent condensation from falling onto the media. The consistent incubation environment may speed plate growth, allowing users the option to validate early plate reading and reporting to physicians. PhenoMATRIX software allows users to pre-assess and sort culture plates. Laboratory professionals can read, interpret, and segregate bacterial cultures with the click of a button, allowing them to decrease time to results so clinicians can make a differential diagnosis faster [00:06:00] and start treating patients sooner. After incubation, users access plate images screened by group. Plates with no growth or no significant growth can be rapidly resulted and sent directly to the disposal with no need to touch a negative plate. At the reading station technologists view all plates requiring further analysis and choose colonies for identification and susceptibility testing. Plates requiring workup are sent to removable canisters.

Images are presented with tagged [00:06:30] colonies and instructions for workup. The canister system gives labs flexibility to grow and change, adding more stations without having to add more track. The Colibri system simplifies laboratory workflow, helps to maintain traceability and reduces manual setup time for AST and ID workup. Plates are loaded onto Colibri and scanned to identify which AST or ID tasks are needed. The system picks colonies based on digital coordinates chosen by the user seeds, [00:07:00] MALDI-TOF target plates and matrix is applied. For antibiotic susceptibility testing, colonies are seeded in a primary McFarland suspension tube and opacity is checked and aliquot is transferred into the manufacturer's McFarland tube. A purity plate is prepared and all outputs are barcoded for traceability. Your automation decision is an important one and we know the choices that your lab makes are critical for your growth. Please contact our team with any further questions or requests and good luck on your automation journey.

Our administration decided to move the facility and to bring in total lab automation at the same time because it allowed us to basically design our facility around the instrumentation, to put the instrumentation in here when we were not here working on it, you didn't have to work around the whole thing. So it was really [00:12:00] a good twofer for us. We were able to get both of those done at the same time. It was still stressful. It still caused some headaches to get it going, but made it that much better than what it would've been.

It is very customizable, which is good and bad because I was like, the place a few hundred miles down the road, they have WASPLab and they have the same LIS. Let's just copy and do everything that they did, just make it a package [00:14:00] and it doesn't work that way. It's very customizable. Which means when you get to the finished product, you've got something that matches with exactly how you do things, how you report organisms, how you work it up, how you plate, all that stuff. So the end product is what you want it to be, but it means that there's a lot of build that goes in place.

You probably also need to work on your staff to get them involved. I'd like Christina [00:14:30] to talk more about that because she's more in that area, but getting people on board is an issue.

You're going to have what you get. The couple things that knocked it over the edge for me for WASPLab was one, we've been Beckman people for a while. We've had Microscan [00:17:00] since before I ever got here, and we've got a good working relationship with Beckman. We like the Beckman people, they're not too annoying. So we have a good working relationship with the Beckman people. But the other thing that I noticed when we went to look at these is that the people who had WASPLab just seemed to be a little bit more enthusiastic about it. They were a little bit more at ease with using it than what we saw with the [00:17:30] other systems. So I was like, that tells me a lot because what I want is our people to really be happy with it, to not be annoyed by it to any great extent. So yeah, that's pretty much what it was, was is that we got along with Beckman, we had a good relationship with Beckman and there seemed to be more enthusiasm for the [00:18:00] WASPLab among those who had it.

And then on the back end, the WASPLab portion with the plate reading, how much that improves your workflow depends on some factors that you have to build into it. When you first start, it may not seem like it too much, but as you get used to it and you can implement it more, it becomes better at that. We can see the effects here where prior to it when we [00:19:30] had people staying late, working overtime trying to finish the workflow and now they're packing up and going home, and I'm like, where is everybody? The work was done for the day.

Another argument in favor of this turnaround time, you're going to improve your turnaround time. And that's something that I harp on a lot is I want to improve our turnaround time. It's hard for us to really judge that here because this implementation [00:20:00] of lab automation took place at the same time that we moved off our main campus. So we rely more heavily on couriers now. So we have to add in the courier time to our turnaround time. So if I sat down and really looked at our turnaround time at this point I'd probably say there's really hasn't been much of an improvement. To get to that point, what we want to be able to do is to do plate reading around the clock because the one thing [00:20:30] that really bugs me a little bit about automation is now I have that screen there which shows you this is when all these cultures are going to be ready for someone to read, for someone to look at.

And it's the same thing as it was before. It's just you didn't have a screen there showing you that this culture is going to be ready to read at eight o'clock in the evening and nobody's going to look at it until the next day. So you really want to get to the point where cultures are read when they are ready, [00:21:00] not once a day, not twice a day, but exactly at the time when they're ready to be read. This allows you to do that, but there's some staffing challenges there. So Christina can probably to get to that better than I can.

So we have had several techs that are able to read plates on second shift and they really do enjoy it and they're great at it. So ideally right now we're just doing urines, we're moving towards training on other culture types as well. On [00:22:30] second shift, we are fortunate to, with our creative staffing, I do have a second shift senior technologist, so she's in charge of the training on second shift and she will be the first one to learn other culture types. So even though you have this automation and it's great and you've got a lot of opportunities with it, you also have to decide, it's like here's the world, what do you want with it? So how do you make it work for you and in a timeframe that works for you? I think that's the biggest challenge because I thought, [00:23:00] oh, we can do this all right away and that's just not. But we're moving towards that so I do think that is a real positive for us.

So you know how techs are, they're going to say, "Oh my god, we're so busy, we're so busy, we're so busy." I'm saying, "Well, you're all going home at the end of the day not having to work overtime like you used to." So that's one of the big things is it's not so much that we can cut people [00:27:30] because if you think about it, financial justification for this is difficult to do. The hard dollars that you would save is going to be in less staffing, cutting people. And so administration might make you think, we're going to look at it and say the only way to get total lab automation is going to be to cut people. And that's not really the case. We don't pay our people that much, [00:28:00] but it allows you to increase the volume without having to add additional staff and that's a more palatable way to talk about it.

There's also, [00:36:30] like I said, no delay in plating the cultures. As they come in, they get loaded on WASPLab and as they're ready to be read, they are read. We in our lab are very limited by space, so we have to use all shifts to the maximum potential to be able to have enough plate readers to read all the plates and we need to separate those plate readers throughout the day.

So traditionally when you're in micro, you get the culture after three days and maybe it's overgrown with Brodeus and you have a bunch [00:40:30] of things growing underneath and you think, "Oh gosh, this is my first day working. Someone else worked on it the previous day. What the heck did this look like on the first day?" We have those pictures so you can go back and look and say, "Oh yeah, okay, Brodeus really wasn't the predominant organism on the first day. I see why they took this course or this is the way the culture needs to be worked out."

Okay. Thank you all for joining us today. Now we're entering the live question and answer phase. We've already had a few questions submitted, [00:46:00] but I do want to let all of the attendees know that there will be two polls that will appear on your screen, so please do respond to those so we have your thoughts on the presentation today and your thoughts on automation in general. Okay. So the first question, let's see. Microbiology is a lot more complex than the other core laboratory disciplines. [00:46:30] A glucose is a glucose, very easy to interface. Can you talk about the LIS interface build and implementation process? So why don't we ask Norton Health because I know your team was intimately involved in that.