Automation in the baking: What’s proofing in this Singaporean lab

By Jaz Low

Interview with Dr Partha Pratim De, Head of Department of Laboratory Medicine, Tan Tock Seng Hospital.

“Automation in medical diagnostics is like baking cake with a packet mix,” Dr Partha Pratim De, Department Head of Laboratory Medicine at Tan Tock Seng Hospital says. You could go through each laborious step to assemble the tasty treat, but there are ways to speed up the process.

The hospital’s Department of Laboratory Medicine (DLM) has turned to automation to taste the sweetness faster. It is responsible for running diagnostics tests for cancers, Covid-19, and other diseases.

Dr Partha shares how automation has sped up diagnosis, reduced human errors, and overcome staff shortages. He also highlights how the lab is gearing up to take on future outbreaks.

The last plastic loop that broke the camel’s back

DLM uses automation to speed up the process of growing bacteria. By studying the colonies in a patient’s sample, staff can tell if someone is suffering from a bacteria infection. They can also determine whether the prescribed antibiotics are working for an affected patient.

Before, staff had to endlessly swab culture plates with plastic loops to isolate bacteria colonies. But now, the hospital has introduced a machine that does this automatically, saving time and energy.

The conveyer belt delivering culture plates to the incubator.

Automation is also shortening the time needed to analyse the colonies. After swabbing, a conveyor belt delivers the plates into an incubator, where a digital camera takes pictures of the bacteria clusters formed.

“Now, when people come to work, they only need to make sense of the culture plate images,” Dr Partha shares. They can fully devote themselves to analysis, which is a lot more productive than performing repetitive tasks.

A staff member observing culture plates from his computer screen 

All this means that patients no longer need to wait as long for staff to generate their test results. One of the bacteria that staff look out for is the MRSA Superbug, which causes infections in different parts of the body and is resistant to commonly used antibiotics.

Before automation, only one-third of MRSA test results took 25 hours or less to generate. But now, machines have greatly shortened this time, and staff can get their hands on most reports within 20 hours.

Moving forward, Dr Partha shares that obtaining results may get even faster. By analysing wavelengths of light that are undetectable to the human eye, scientists can identify bacteria colonies even before their growth is visible.

Staff no longer need to incubate the culture plates overnight and can receive results within a few hours.

This information will help them to determine the cause of bacterial disease and how serious the infection is. So when there are limited hospital beds available, “patients who require immediate care do not lose their slot to someone else in lesser need,” he says.

A guide to testing 2,000 Covid samples in a day

At the peak of the pandemic, DLM looked into automation to improve productivity and reduce staff fatigue and errors. Tech provided some respite for the department as it was testing close to 2,000 Covid samples a day.

DLM has a machine that dispenses precise and consistent volumes to test for Covid. This step used to be manual, requiring full concentration and steady hands of trained medical technologists. But “our hands and brains may get tired and slip-ups do happen,” Dr Partha says.

Now, staff only need to load the samples into a machine and technology will get the job done accurately. With machines, staff have also been able to test a larger volume of samples at one go.

Staff loading sample into the machine for Covid testing

Automation helped to solve the problem of employee testing as well. “Every week, we had to test 12,000 hospital employees and that was a huge challenge,” Dr Partha recounts. The department was not prepared to test samples on such a large scale then.

“People had to work longer hours and come back on the weekends to get staff testing done,” he shares. Employees had to wait around three to four days to receive the results, but later they were able to get them the same day.

No labour, no problem

Samples arriving at the DLM from the tube system

The DLM has also been a consistent pillar of support for the National Centre for Infectious Diseases during the pandemic. The latter had to test thousands of samples round the clock, so the former stepped in to relieve some of the workload.

Staff stored the samples in tubes and transported them across a pipe that connects the two locations. This minimised any delays in transportation and ensured a rapid turnaround of Covid-19 testing.

Laboratories worldwide face the same challenges to innovate and constantly meet the growing demands for disease investigation. Automation is the cherry on top to enable them to deliver accurate test results quickly, so clinicians can make informed decisions.

This article was written in celebration of World Lab Day, observed annually on April 23. Pictures courtesy of Tan Tock Seng Hospital. This article has been revised for accuracy.