By Bernadette Seward
Automation of laboratories offers opportunities for medical laboratory technologists.
What can medical laboratory technologists (MLTS) do today to prepare for the laboratory of the future? Opinions vary. The National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) recently produced a white paper on the subject, entitled The Laboratory Professional of the Future. It suggests that upcoming technological advances will make existing job descriptions for technologists obsolete. It also predicts that educational requirements for entering the profession, and the lifelong learning requirements for remaining relevant in it, will change in response to advances in noninvasive testing, community and home testing, and point-of-care testing.
A Glimpse of the Future
Laboratories that have already invested in new systems offer valuable insights into how skill sets are changing. Toronto Medical Laboratories (TML) was established in 1995 as a joint venture partnership between the three teaching hospitals of the University Health Network and MDS Inc., one of the major suppliers of automated lab systems in Canada. Over the past three years, TML, a C$57 million laboratory, has developed an advanced laboratory information system (LIS) infrastructure. The implementation of Triple G's Ultra at an off-site core lab and at three rapid response laboratories, as well as a wide variety of other interconnected laboratory systems, has challenged the TML team to adapt to new ways of doing things. Behind TML's transition to a high-tech laboratory is a diverse and committed group of about 600 laboratory staff, including 350 MLTs. Only eight are working full time as LIS specialists.
Lindsay Campbell, the director of laboratory information services at TML, says there are few other Canadian laboratories that have gone as high-tech and fully automated as TML: "The TML investment in technology puts us in a unique position to learn how the technologist's role needs to change."
Peter Woo is one person who has already made the transition from an MLT to an MLT with strong LIS skills. He completed a degree in computer science, part time, after graduating with an MLT diploma. Now, he combines his computer and MLT skills to perform his LIS role. "I think MLTs need training in many new areas, such as laboratory operations, data management, data integrity, data evaluation, and project management, to move into LIS positions," he says. "Like all health professionals, MLTs have always required a great deal of scientific and technical knowledge to enable them to perform their professional role. The changes taking place in the laboratory will require MLTs to expand their knowledge bank – but they're up to the challenge."
As for lab work now, Woo says, "It no longer takes five hours to do a manual sodium today. Technology enables us to process large volumes of work; it's the future."
LIS Expertise in Demand
A recent article by Greg Miller in the Clinical Laboratory Management Association journal, Clinical Leadership and Management Review, supports Woo's views. Miller describes how LIS workers often program "automated" reports on such things as thresholds for turn-around times, work load, epidemiologically significant results, and specimen tracking, and then translate these reports.
"We manage the data the technology generates, the system hardware, software, applications functions, interfaces, billing and reporting," explains Woo. "MLTs with LIS expertise can assist with the management and use of automated reporting processes to raise the quality, effectiveness and efficiency of the lab. They also provide training for new staff, and respond to issues or needs as they arise."
According to Campbell, the number of LIS positions needed in laboratories is increasing and will expand significantly over the next five years. The technology will continue to evolve, freeing up MLTs to perform more analysis, highly specialized testing, research and development, clinical trials, and implementation and evaluation of new tests. The quality control role of MLTs may even include providing physicians with input concerning test selection.
"While it's a challenge for any of us to learn a new skill, the automation of laboratories offers a lot of opportunities for MLTs," says Devon Piirto, director of automation technology for MDS Inc. Piirto believes MLTs have no reason to be concerned, because "people who are MLTs, for the most part, already have the logical thought processes (that they'll need to succeed)."
Campbell agrees. "I think it's critical to understand that the career transition from the MLT to the MLT with LIS expertise starts and finishes with being a member of the MLT team," she says. "Their credibility is based strongly, if not entirely, on the fact that they are lab professionals first." After this, Campbell says, computer science and information management courses are needed. An MLT background paired with a programming degree or diploma gives MLTs an edge to move into LIS positions.
MLTs have always been expected to understand the instruments in their laboratory. "The big difference is that it doesn't stop at the instrument anymore," says Woo. "It's all about thinking beyond the instrument and working with the information coming from the instrument. It's also about understand the quality of the test, the utilization of the test, analyzing clinical trends ... it's looking at how thousands of results link together."
Changing Roles of MLTs
|MLT – LIS Specialist||Experts in the use of technology in the analysis, management and reporting of laboratory testing data.|
|MLT – Laboratory Leader||Laboratory systems integration is creating new leadership approaches: 1. Managing in a multi-site environment linked by systems. 2. Managing staff who manage data.|
|MLT – Quality Coordinator||Increasing demands from accreditation and regulatory bodies are creating opportunities for quality coordination positions.|
|MLT – Point of Care Testing Coordinator||Clinical Liaison Expansion of the use of point-of care tests and the expansion of the platforms linking these tests is creating roles for MLTs to assess the value of the test, monitor the implementation and use of the test, and coordinate the testing data.|
|MLT – Business Development Roles||As laboratories become increasingly able to collect and mine data, a new role is emerging for MLTs to influence clinical decisions and manage test utilization. MLTs are well positioned for roles that blend technical expertise with marketing and client service skills.|