The main reason that automation has developed at a slower pace within histology than in the clinical laboratory, is because many of the manual histology steps have proven more difficult to automate and standardize. In addition, the orientation to batch histology processing has been closely tied to the limitations of traditional instrumentation, such as the vacuum tissue processor shown in the image. These instruments typically have cycle times extending 8 to 10 hours or longer. Even the long cycle times of traditional instruments were an improvement over the previous completely manual processes, but still resulted in long wait times and bottle necks between the intermittent automation within the workflow.
It has been estimated that despite some automation, about 70% of the workflow in a typical histology laboratory remains manual. As a result, many of the mostly artistic and labor intensive manual steps have persisted between the intermittent technologies available. However, with increased testing volumes and staff shortages, the inefficiencies and inconsistencies caused by a mostly manual work process have become magnified. This has resulted in more attention to the problem from laboratory leaders and vendors. In recent years, more development and innovation of histology automation and workflow assisting technology has occurred than ever before in the history of the practice of histology.
The table below outlines some histology workflow steps that can be made more efficient and accurate with technology:
- Laboratory information system (LIS) integrated cassette printer with barcode identification capability
- Rapid processing with microwave technology
- Reduces cycle times from over 8 hours to 1-4 hours
- Automated embedding instrumentation
- Automated microtomes, cutting station readers, and label printers that are LIS integrated
- Automated staining instruments that integrate with the LIS, access the patient database, and perform case completion tracking
- Many also perform deparaffinization, antigen retrieval, and coverslipping
Click on the link below to find some common sources of error and possible corrective measures.