Clinical diagnostic laboratories are under growing pressure to handle higher testing volumes, shorter turnaround expectations, and navigate labor shortages. Automated chemistry lines have become a popular solution to help manage this workload. These systems are effective for high-throughput assays, where consolidating high-throughput routine chemistry tests onto a single line can maximize staff resources, automate pre-analytical steps, and optimize use of laboratory space.1
Special protein testing, however, brings unique requirements that can introduce inefficiencies when performed on chemistry lines. Recognizing these challenges is important for laboratories aiming to maintain efficiency without compromising quality or reliability.
Where automated lines fall short for special proteins
A major concern is the need for manual intervention. Special protein assays often have wide measuring ranges and can require multiple dilutions, and reliable antigen excess detection. Chemistry analyzers are not always optimized for these needs, so technologists may need to perform offline dilutions. 2-3 Offline dilutions not only interrupt automation, but also add hands-on time, and increase the risk of result variability.1,4
Turnaround time can also be affected. Special protein assays can involve longer protocols and additional wash steps. Because chemistry lines are designed for rapid, routine assays, the extended run times for special protein tests may slow the entire system. While these assays are running, other tests may queue behind them, creating unnecessary delays in generating results for routine tests.
System reliability is another factor. Automated lines are complex instruments with multiple modules and moving parts, which may lead to higher rates of downtime. When a line is unavailable, every assay that runs on it is disrupted.4 For laboratories already working under tight deadlines, this may create significant operational challenges.
The impact of calibration and QC requirements
Calibration and quality control requirements for special protein testing is also demanding. A study conducted at Hennepin County Medical Center highlights this point.
Calibration for a Freelite assay on the Optilite® protein analyzer* required just over 30 minutes, compared with more than 60 minutes on a chemistry line. The same study found a 50 percent reduction in routine monthly maintenance when protein testing was moved from the line to Optilite protein analyzer.3
Antigen excess detection is another consideration. Without reliable safeguards, there is a risk of reporting falsely low results when excess antigen is present. Dedicated protein systems, such as the Optilite protein analyzer, are often designed to address this need more effectively than chemistry analyzers.3
Assay availability can also limit workflow. Not all special protein tests are validated for use on chemistry systems, so laboratories may need to send out samples or reduce their menus, which can extend turnaround times for patients and providers.
Taking a closer look at workflow design
Automated chemistry lines serve an important role in modern laboratories. For routine, high-volume assays, they bring efficiency and standardization. The challenge is how to integrate special protein testing without creating new inefficiencies or risks.
Many laboratories have found that separating protein assays from the automated track environment leads to measurable improvements. The Hennepin County study showed that by moving special protein testing from the track system to the Optilite protein analyzer not only reduced calibration and maintenance but also faster turnaround times for assays that otherwise required manual dilutions. In that evaluation, the average turnaround time from specimen receipt to result verification on Optilite protein analyzer was less than one hour.3
Reducing manual interventions also supports the workforce. In laboratories where staffing is a challenge, minimizing repetitive dilution steps and lengthy calibration runs can allow technologists to focus on more complex tasks. Streamlined workflows can help address workforce pressures while maintaining high-quality results.1
Ultimately, the decision is not about whether automated chemistry lines are effective. They are well suited for the high-volume assays they were designed to manage. The question is whether special protein testing belongs on them.
By weighing the specific requirements of individual assays, including longer protocols, intensive calibration, antigen excess detection, and broad dilutional needs, laboratories can make informed choices about where they will see the greatest efficiency and reliability.
In today’s environment, where laboratories are asked to deliver more with fewer resources, thoughtful workflow design is essential. Recognizing the limitations of automated lines for special protein testing is an important step toward aligning testing strategies with both operational efficiency and patient care.
*Optilite is a registered trademark of The Binding Site Group Limited (Birmingham, UK) in certain countries. Other brand or product names may be trademarks of their respective holders.
References
- Boyd, J. C., & Hawker, C. D. (2022). Automation in the clinical laboratory. In N. Rifai, A. H. Horvath, & C. T. Wittwer (Eds.), Tietz textbook of clinical chemistry and molecular diagnostics (7th ed., pp. 469–485). Elsevier.
- Ghillani P. et al. Analytical performances of Optilite® turbidimeter (The Binding Site): a new dedicated analyser for specific proteins determination. Ann Biol Clin 2017; 75(1): 29-37
- Saenger et al. Improvement in Workflow and Efficiency for Measurement of Special Proteins Using the Optilite®Standalone Automated Analyzer. Performed at Hennepin County Medical Center, Minneapolis, USA. Presented at the 2021 AACC Annual Scientific Meeting & Clinical Lab Expo, September 26-30, 2021 in Atlanta, Georgia.
- Armbruster, D. A., Overcash, D. R., & Reyes, J. (2014). Clinical Chemistry Laboratory Automation in the 21st Century - Amat Victoria curam (Victory loves careful preparation). The Clinical biochemist. Reviews, 35(3), 143–153.
