Lean, Automation and the Medical Lab

July 3, 2017

Everyone is a potential healthcare customer, so leveraging automation and lean may provide some critical benefits.

When one thinks about the healthcare industry in comparison to other industries over the last couple decades, there are some specific challenges to face going forward. Take the demise of manufacturing in the U.S. According to some experts I have read lately, healthcare costs as a percentage of GNP are expected to surpass the value of all manufacturing in the U.S. any day now. We are grappling with escalating increases in healthcare costs in the double digits every year. As America ages (and I certainly qualify myself!), the demand will only increase.

Clearly, the increasing annual costs of healthcare are not sustainable in the long run, and almost everyone I know is either very concerned or extremely alarmed about it. So, what is the answer?

There are no simple answers to these complex problems, but I do believe that lean, Six Sigma, Lean Six Sigma (which I teach in Villanova University’s professional online program) and advanced applications of technology and automation offer the best short-term answers to these problems. I’m happy to say that there are leading providers in the healthcare arena who are taking the lead. Certain organizations in the medical industry are aggressively pursuing lean and automation as a direct response to the needs of the marketplace to maintain and improve quality performance while increasing speed and controlling costs at the same time.

Take, for example, the intake operations for a large medical institution’s clinical labs. These labs identify, label and route specimens from thousands of medical providers (e.g., hospitals, clinics, etc.) to a large number of internal and external labs for testing. There are unique problems associated with keeping the specimens stabilized and dividing (aliquoting) a given specimen for multiple tests. The specimen processing procedures in any clinical laboratory are the most labor-intensive tasks and are subject to human error. Specimen processing has two components—identifying and providing storage and temperature control for specimens en route for lab testing.

For our APICS crowd, this means labs have a logistical supply chain challenge of a magnitude few of us ever experience. Imagine this. What are the chances that thousands of medical businesses are all going to label and identify everything the same way? Or that they would send the specimens at the same time or at an appointed time? How many mistakes do you think the organizations are likely to make on the thousands of in-bound paperwork and specimens every day? The short answer is that there are many problems to overcome.

At the same time, customers’ demands are very high. Quality of results must meet or exceed Six Sigma levels of performance because people’s lives hang in the balance. What about pressure on lead times? Intense! What about cost? All of us are customers who want the costs for medical services to be controlled and reduced. At the same time, the industry is experiencing strong growth, and a shortage of skilled technicians is looming. Avoiding the addition of bricks and mortar is desirable to keep costs in line.

Faced with many pressures, one organization has been embracing lean and Six Sigma to continually focus on quality, simplify the work and reduce wasted human effort. In its business, quality is always first along with a realization that relying on human eyes will never get the organization to where it needs to be.

During value stream mapping and studies of the business processes, the organization took the logical steps of analyzing the statistical characteristics of in-bound specimens. As is usually the case, the Pareto analysis of the data suggested a relatively small number of specimen types, and client medical providers represented a large percentage of the population of specimens to process. A ripe opportunity to apply automation was recognized.

The organization chartered a project to allow for scalable automation capable of handling thousands of specimens per hour and initially routing them to more than 100 delivery locations. The automation provided benefits, including:

  • Reconciliation of specimens to the client institution’s electronic shipment records and triggering corrective action when discrepancies are found
  • Reading barcodes in various formats to speed up recording and eliminate human work and data entry errors
  • Uniquely coding each individual specimen for tracking throughout the value stream
  • Increased rate of workflow to keep up with spikes in system inputs
  • Reduced turnaround time of 50 percent or more—much faster than what is possible with human handling techniques
  • Reduced human intervention—such as picking up specimens and reading them for various steps before lab testing—has been reduced to a single touch at the receipt point versus a half-dozen or more touches before the automation project

There are many benefits to the workforce that were identified by worker teams long before the automation project was a reality. Some of those benefits from automation include:

  • Less stress in dealing with repetitive tasks, such as repetitive reading and keying in data and manual verifications
  • Fewer disruptions to deal with human errors
  • Freedom to focus more time on the customers’ problems

Careful consideration in communicating about automation and then focusing on the things that improve quality and workforce productivity is critical. Leveraging automation in your lean endeavors does this and is a key to future competitiveness regardless of your industry.

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