As the analytical power of liquid chromatography tandem mass spectrometry (LC-MS/MS) gains ever more recognition, a rising number of clinical laboratories are implementing it across a growing range of applications. However, despite its capability to analyze multiple analytes with greater specificity and sensitivity than conventional immunoassay-based methods, the technique has not been widely adopted, and laboratories have been hampered from being able to harness the power of this gold standard technology to help optimize quality, workflow and turnaround times. In a discussion with Dr. Victoria Zhang of the University of Rochester, an expert in clinical mass spectrometry, and the Founding Chair of the Mass Spectrometry and Separation Sciences Division from the American Association of Clinical Chemistry (AACC), we unravelled the importance of automation in promoting mainstream LC-MS/MS implementation.
As a keen advocate for LC-MS/MS based clinical testing, Dr. Zhang is fully aware of the struggles many laboratories face when they consider implementing LC-MS/MS systems. One important issue is that only staff with highly specialist knowledge can use current LC-MS/MS technology, as it is particularly complicated involving separate instruments connected together and managed by the lab, laboratory developed and validated test methods, and many manual steps which are labor- and time-intensive. These factors make current systems prone to errors, and can limit the laboratory’s productivity. Although they may desire the quality, due to the high level of personnel expertise and training required, as well as substantial initial capital expense, many clinical facilities have not considered LC-MS/MS as being an adequately efficient or cost-effective testing method.
Automation is key
Dr. Zhang has identified the lack of fully automated and fully integrated LC-MS/MS analyzers as one of the key barriers preventing clinical laboratories from adopting this powerful technology. Such systems would eliminate the manual steps, thereby reducing the potential for errors, increasing turnaround times and improving consistency of results. Facilities will benefit from enhanced workflows and overall productivity gains, allowing them to provide an improved service to healthcare providers and their patients.
The road to success
Dr. Zhang summarizes the current situation using the following analogy: “Automation to LC-MS/MS is like highways to cars. We have great technologies in LC-MS/MS, but we need to build a streamlined system and platform to fully utilize its potential in the clinical world. Automation is the solution; it will enable us to use the great tools we already have in place to better serve patients and to take us into a brighter future of healthcare.”
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