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Toward the Earlier Provision of More Reliable Test Results

- Evolving Automated Testing Systems -

Sample testing supports the early detection and accurate diagnosis of diseases by highlighting a variety of signs.
Our goal is to build a system that can contribute to the QoL of people using data analysis and robotics.

Laboratory of the latest testing environment

What is Sample Testing?

Everyone occasionally experiences fever, sluggishness or pain somewhere in their body. Although doctors may begin their diagnosis by listening to the patient and then examine their body with a stethoscope, sometimes this is insufficient to identify the cause and determine a treatment strategy. On such occasions, doctors may collect samples from the patient, such as urine or feces, or blood as a body constituent. This is sample testing, which is a part of laboratory testing as well as physiological function testing, such as an electrocardiogram or an electroencephalogram that directly investigate the body’s functions.

Laboratory testing plays an important role in a doctor’s clinical decision making in the early stage of diagnosis for a patient with a suspected disease. In the laboratory tests, blood or urine sample testing is performed as often as diagnostic imaging. Many people may have experienced blood or urine collection after being examined by a doctor at a hospital. Sample testing can be performed easily on site without taking much or requiring a reservation, but it enables understanding of the signs of a disease and increases the accuracy of a doctor’s diagnosis.

Blood consists of cellular components including red blood cells, white blood cells, platelets and plasma, which contains carbohydrates, lipids and water that accounts for 90% of the volume. By testing counts or forms of red or white blood cells, the possibility of anemia or decreased immune function can be found. Also, the possibility of other conditions can be found, such as arterial sclerosis/hyperlipidemia based on values of cholesterol and neutral fat in the blood, diabetes based on blood glucose, fatty liver/hepatitis/cirrhosis based on liver function results, and gout/kidney failure based on kidney function results. Allergies and infectious diseases can also be detected through blood testing, while renal insufficiency or diabetes can be detected by urine testing.

Sample testing provides a lot of information on the body. That is why a huge number of sample testing is performed every day at medical institutions throughout the country.

[Laboratory tests] Physiological function testing (Investigates the patient’s body itself, for example, ultrasound, CT, MRI and ECG)(Investigates components (samples) collected from the patient’s body,
for example, blood, urine, feces and tissue)

Evolving Automation of Sample Testing

Sample testing was performed visually and manually until the 1940s. An automated analyzer made by an American manufacturer entered the market in the 1950s, and then testing automation began with red blood cell counting. In the 1960s (1970s in Japan), white blood cell counting was automated. In the era when all tests were performed manually, testing per sample took much longer and accuracy varied depending on the skill level of the laboratory technician. As automation evolved, issues with both accuracy and speed improved.

Test items varied as healthcare developed and the need for more prompt testing grew. Along with efforts to shorten the time for analysis, automation of pre-analytical preparations and necessary tasks in the course of testing were pushed forward. In the efforts for automation, Hitachi has focused on the process of aliquoting.

Aliquoting is the process of dividing a blood sample in a blood collection tube into specimen containers, according to the required sample amount for each test item. Traditionally, a laboratory technician draws a certain amount of blood from a blood collection tube using a dropper (aspiration) and distributes the content into specimen containers (discharge). With such traditional methods, work efficiency and the bouncing of blood during distribution that causes contamination remained to be solved. Automation of the aliquoting process did not only lead to considerable time-saving in pre-analytical preparation, but also improved the quality of testing.

To date, Hitachi has contributed to the achievement of more speedy testing by suggesting modules that automated detailed work, such as the de-capping of a blood collection tube and the bar code labeling of daughter specimen containers. In addition, with a transport system that connects these modules or a variety of analytical devices to exclusive transport lines using IT, the work that used to be performed by laboratory technicians were automated and the traffic lines were rationalized.

Putting five samples on a rack and facilitating its transport among a variety of blood analysis devices

Pre-analytical preparation system that automated the tasks previously done by laboratory technicians

Further Evolving Sample Testing by Introducing IoT* and AI*

SRL Inc. is the largest clinical laboratory testing company that receives specimens from medical institutions and performs sample tests for about 200,000 people per day in about 90 laboratories nationwide. SRL Advanced Lab Azabu, located in Minato-ku, Tokyo, is the laboratory where a variety of systems that enable manpower-saving and automation were introduced. The lab also functions as a showroom for customers, performing sample testing for about 2,000 people per day. Hitachi’s high-performance aliquoting system, transport system and robotics technology were introduced at the lab.

Ms. Noriko Maruyama from the Tokyo Testing Department, SRL, Inc. said, “In our central laboratory in Hachioji, Tokyo, special tests such as gene or chromosomal testing are performed, and these tests have been our competitive advantage. Along with the growing needs of practitioners/clinics for general testing, arising from the recent family doctor policy or a thorough or standard medical checkup, we opened a new laboratory in Minato-ku, where many practitioners run their clinics. We perform general tests requested by doctors in Minato-ku or circumjacent clinics.”

“Recently, the speed of returning test results is viewed as important. For example, in a half-day thorough medical checkup, a patient will undergo blood and urine collection soon after visiting the clinic. Then they will undergo all examination items and receive a diagnosis that reflects the sample test results before going home. This schedule has become common. Therefore, we complete about 110 types of sample tests in about 30 minutes at the earliest to transmit feedback through electric medical records. Of course, we are also pursuing the accuracy of test results, which our doctors and patients appreciate.”

Ms. Noriko Maruyama, Senior Manager,
Minato Testing Section, Tokyo Testing Department, SRL Inc.

More specimens are brought into laboratories in the late afternoon and the night, after business hours have ended. Laboratories operate on a 24-hour schedule and test results are reported by the next morning. However, in order to address any lack of laboratory technicians and promote work-style reform, manpower-saving during the night and robotic operation, which was introduced on a trial basis, is also being promoted. “In the future, the introduction of IoT and AI in the process of testing/analysis will spread. This will improve test accuracy and automate the task of identifying many images,” said Ms. Maruyama.

Hitachi will continuously make efforts toward innovations in healthcare by utilizing robotics and digital technology.

*IoT: Internet of Things

*AI: Artificial intelligence

In SRL Advanced Lab Azabu,
a robot identifies samples that require re-testing and returns it to the testing process

Toward the earlier provision of more accurate test results
Masaaki Watabe
Senior Director,
Analytical Systems Design Division,
Analytical Systems Division,
Healthcare Business Unit,
Hitachi, Ltd.
Provide Faster, More Accurate Test Results Masaaki Watabe Senior Director, Analytical Systems Design Division, Analytical Systems Division, Healthcare Business Unit, Hitachi, Ltd.

“Hitachi, a pioneer in developing the high-precision aliquoting system, has supported streamlining of sample testing for more than 40 years. While digital technology such as IoT, AI and robotics has drawn attention, opportunities to make use of factory-cultivated techniques and experience are increasing,” said Masaaki Watanabe, Analytical Systems Division, Hitachi Healthcare Business Unit. What is the advantage of Hitachi in sample testing system?

Many sample tests are performed mainly at in-hospital and central laboratories. Although highly-accurate testing is important in all laboratories, the efficient provision of test results in a short time is required especially in central laboratories, where a large number of specimens are brought. Each lab has a different size and shape, and also different analytical equipment being used differently. Therefore, we listen to each customer’s needs in detail to suggest the best sample testing system that features the best transport line and aliquoting system as its main component. In addition, we offer a lineup of modules for the automation of detailed work, such as a module for de-capping of various blood collection tubes and a module for bar-code labeling of daughter specimen containers in order to prevent sample mix-ups. We use our products to design laboratories in order to meet each customer’s unique needs. The ability to implement the most appropriate customization for the detailed needs of customers is one of Hitachi’s strengths.

Utilize Experience in the Application of Digital Technology for a Variety of Industries

By listening to customers’ needs, we sometimes encounter challenges that cannot be solved only by healthcare expertise. For example, if a sample testing system that includes various modules is suddenly disrupted, an enormous amount of testing would stop, which could result in life-threatening situations. We can give our customers a sense of safety by suggesting the introduction of preventive diagnosis technology for events including equipment failures, which have been utilized to date in the process of manufacturing by the Hitachi Group.

In central laboratories, sometimes there were not enough transport to transport numerous samples and the installation of additional transport lines could result in complicated traffic lines of laboratory technicians. To address these problems, we suggested the introduction of AGV* or a two-armed robot, which was used in logistics and manufacturing industries. Utilizing experience in the application of digital technology for a variety of industries has led to expanded options for solving problems.

The next step for us is to build a system to track sample testing. Even though test results can be obtained in a shorter time than before, patients may become anxious while waiting because of a health issue. Also, spending a long time at the hospital may be difficult for children and elderly people, and for those who accompany them. Therefore, we think that tracking and visualizing the testing process would enable patients to know in real time which process of the testing has been completed or how much longer it will take, reducing the patients’ frustration and burden related to time.

In addition, we wish to pursue unmanned laboratories using IoT and AI. In fact, sample testing can be performed more speedily without variability in the time needed for testing when human hands are not involved. Our future goal is to realize manpower- or labor-saving tests by centrally controlling multiple testing processes from a place similar to a command room for a train traffic control system.

*AGV: Automated Guided Vehicles (unmanned carriers)