Automated microbiology systems. An ECRI technology assessment

Microbiology is the last of the major labor-intensive sections remaining in the clinical laboratory; other large, previously labor-intensive areas--chemistry and hematology--were automated over the last two decades. Only in recent years has technology been developed to permit automation of microbiology techniques. This assessment describes the historical development and technological aspects of automated microbiology systems. Patient care can be improved by earlier treatment and reduced lengths of stay when clinicians use the rapidly reported information provided by automated microbiology systems. Automated systems may reduce the cost of microbiology testing; whether savings are realized depends both on the manual methods to which the automated technology is compared and also on the particular automated system under consideration. Some studies indicate that the technology is cost saving when used on a large scale; other studies show that, while automated microbiology technology extends laboratories' capabilities, the technology can increase laboratory testing costs. Since automated microbiology systems cannot result in cost savings in every application, it is a technology that should be carefully evaluated in its intended setting, before a decision is made to acquire such a system. Adoption of the technology in hospital laboratories has been relatively limited; problems in perfecting the technology have slowed its acceptance. In states with prospective payment systems in place prior to 1983, hospitals' acquisition of automated microbiology systems has been even more limited.