By Joanne Toohey, BSMT, ASCP and Allan Trochman
Imagine a central laboratory where instruments never break down, and everything runs reliably around the clock with only minimal preventative maintenance. While this scenario does not depict reality for most laboratory managers in 2001, the evolving field of remote diagnostics is narrowing the gap between science and science fiction. When remote diagnostics is wrapped in a proactive service approach, the gap narrows further, as lab technologists at Thomas Jefferson Hospital in Philadelphia have discovered. And new technology on the horizon promises to increase instrument uptime even more.
Joanne Toohey, chemistry supervisor for the clinical chemistry laboratory at Thomas Jefferson Hospital in Philadelphia says the Beckman Coulter Synchron LX20 chemistry system equipped with remote diagnostic capability has saved the staff maintenance time.
The term “remote diagnostics” refers to technology that enables an instrument manufacturer’s service team to diagnose device problems at a distance. Essentially, a customer service representative or service engineer uses a dedicated phone line or Internet connection to access a computer in the instrument that tracks performance parameters. These parameters can identify both existing problems and developing situations that have yet to manifest as actual malfunctions.
Proactive vs. reactive remote diagnostics
Most instrument manufacturers employ remote diagnostics technology reactively. That is, when an instrument malfunctions, a call goes out to the manufacturer’s regional field service engineer. By accessing instrument data via remote diagnostics, he or she often can identify the malfunction and speed the repair. Sometimes, the problem can be solved over the phone by directing laboratory staff to make a minor adjustment or repair with parts previously supplied.
If the problem is complicated, the service engineer may need to visit the lab, but remote diagnostics usually enables him or her to arrive with the problem identified and the necessary replacement parts in hand, rather than having to diagnose on site and then go back for parts.
Reactive remote diagnostics can reduce the length of instrument downtime (and thus associated costs), but it can’t actually prevent downtime because it is always employed after a breakdown occurs. In contrast, proactive remote diagnostics may prevent instrument downtime from occurring in the first place, as Thomas Jefferson Hospital has discovered using its Beckman Coulter Synchron LX20 chemistry systems.
Here’s how it works: Each week the Beckman Coulter server automatically dials into the Synchron LX20 systems, downloading vital instrument functions. A report is then generated and reviewed by a service representative who examines the data, looking not only for acute problems but also potential problems indicated by abnormal readings.
This screen allows the remote service engineer to look at the specific parameters of any chemistry test on a customer’s system.
For instance, a readout might show that a motor is drawing more current than it should. The extra current may signal a developing blockage or freeze-up of a part that will lead to an eventual breakdown if it isn’t addressed soon. With proactive remote diagnostics, a service engineer may be able to correct the problem before quality control is impacted.
The service representative also uses periodic monitoring through the remote diagnostics connection to keep “trend reports” on instruments. The reports make it possible to track developing problems that might not be apparent by reviewing a single readout — for example, an increasing frequency of motion errors.
The data event log allows an off-site service engineer to monitor instrument data event logs remotely and pinpoint potential problems.
Proactive monitoring at Thomas Jefferson also has been extended to reagent replenishment. To help keep labs stocked with reagents and minimize lab technologists’ involvement in inventory control, Beckman Coulter customer service representatives remotely monitor reagent usage at pre-arranged intervals. Projecting from the instrument’s usage rate, the company can send out sufficient supplies to keep the laboratory stocked on a just-in-time basis. This frees staff from needing to be involved in taking inventory or ordering.
Remote diagnostics proves its worth
At Thomas Jefferson Hospital, Beckman Coulter’s remote diagnostics technology has proved its worth in all of the above applications. About two years ago, the hospital purchased three Synchron LX20 systems. Since activating the proactive remote diagnostics capabilities last year, the hospital has seen several benefits from the technology.
For starters, proactive remote diagnostics has saved Thomas Jefferson staff time. At the hospital, two technologists are responsible for in-house maintenance of the LX20s. Both have received training from Beckman Coulter, so they can perform ordinary maintenance, either on their own or with over-the-phone guidance from a service representative.
In the event of an instrument breakdown, these technologists would be responsible for getting the instrument back online, taking valuable time away from their regular lab duties. Thanks to proactive remote diagnostics and improved instrument uptime, they spend less time on regular maintenance and more time on other, more important tasks in the lab.
Improvements in uptime at Thomas Jefferson also save overtime pay. For instance, if an instrument breakdown were to occur on the second or third shifts, technologists who ordinarily earn about $21/hr. would be kept overtime to finish the day’s workload. They are then paid time-and-a-half — or more than $31/hr. Proactive remote diagnostics helps keep overtime pay to a minimum. (Note that no existing technology can eliminate downtime entirely. Just as even the best-maintained cars can unexpectedly get a flat tire, it is impossible to prevent all malfunctions in a complex lab instrument with its many moving parts and sophisticated systems.)
Proactive remote diagnostics, which includes automatic reagent replenishment, has helped Thomas Jefferson save even more. Before signing on to the automatic reagent replenishment program, laboratorians at Thomas Jefferson took a weekly inventory to ensure there were plenty of reagents inhouse. Ordering took place at least monthly and often every two weeks. Now, staff members only get involved when extraordinary usage of a particular reagent requires a special order. Staff time saved by automatic replenishment amounts to one- to one-and-a-half hours weekly in inventory-taking and about one hour per month in ordering.
About one year after Thomas Jefferson acquired its LX20s, it agreed to have the remote diagnostics capability employed in full-blown fashion to enhance instrument uptime. As a result, service calls have been reduced substantially, primarily because minor technical issues are resolved before breakdowns occur. Many of the current service calls involve no instrument downtime at all, just preventive maintenance.
The most obvious advantage of proactive remote diagnostics at Thomas Jefferson is the ability to keep the lab instrument’s throughput at its optimum level. Unlike other systems, the one installed at Thomas Jefferson enables engineers to access laboratory instruments in real time — that is, without having to put the instruments in “idle” mode. Since most repairs are made well in advance of instrument downtime, they can be scheduled during ordinary maintenance service visits and lab operations are not interrupted.
Privacy rights
Remote diagnostics does raise privacy issues because, in some situations, the same electronic connection that enables engineers to “see” instrument problems remotely also could give them access to patient data. Always an ethical concern, privacy has become a legal one, too, with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations scheduled to take effect in February 2003.
Fortunately, the Synchron LX20 systems in place at Thomas Jefferson provide a double layer of privacy protection. For one thing, the remote connection only allows access to instrument logs; patient data never enters the system. For another, a complex, ever-changing password protocol ensures that the person servicing the instrument remotely is authorized to do so. These extra prevention measures help ensure that patient test results remain private, eliminating legal and ethical concerns about patient confidentiality.
‘Push’ technology — even more economical remote diagnostics
So what’s the next step in remote diagnostics technology? A major improvement in proactive remote diagnostics involves “push technology.” The term refers to the fact that instruments so-equipped will monitor themselves on a 24/7 basis and “push” messages to service representatives when they need preventive maintenance instead of human beings remotely “pulling” data out of the instrument. This is expected to result in even greater cost savings for laboratories.
The hardware that makes push technology possible is a small, napkin box-size computer that sits outside the instrument. Conceivably, a single such computer would be able to serve all the like instruments at the same site – for instance, the three LX20s in Thomas Jefferson’s clinical chemistry lab — rather than having one computer for each instrument. Depending on the option selected, the alerts pushed to the field engineer are received either as e-mail or as messages on the engineer’s pager or both. The manufacturer provides hot-line telephone support as well as regional field engineers for labs using its instruments. Push technology will improve this service as well, because the hotline operators will be able to access an Internet site that shows trends and the up-to-the-minute condition of all push-equipped instruments.
In addition, the push computers will be loaded with proprietary software that speeds diagnosis of instrument problems even further. That is, once the instrument’s logs are accessed, the software analyzes the data to help the engineer identify the cause of any problems. This is an important factor in increasing instrument uptime.
Push technology is set to debut in field trial form at several hospital sites soon. If the field trials go as expected, the technology could be available to LX20 laboratories within a year. Currently, the technology has only been applied to the LX20, but it may be employed on other Beckman Coulter instruments in the future.
Remote diagnostics is changing the face of laboratory instrument performance. Completely trouble-free, breakdown-proof instruments may be an impossible dream, but many lab administrators would gladly settle for the scenario experienced at Thomas Jefferson Hospital. And with push technology around the corner, remote diagnostics only promises to get better.
Joanne Toohey is chemistry supervisor for the clinical chemistry laboratory at Thomas Jefferson Hospital in Philadelphia. Allan Trochman is a software developer for Beckman Coulter in Brea, Calif., and creates programs to help field engineers diagnose instrument problems.
For more information about Beckman’s remote diagnostic capabilities, Select Reader Service Number 260, go to their Web site (www.beckmancoulter.com) or call 800-352-3433.
