In-house veterinary blood analyzer technology has come a long way in the past two decades, and with the rise of large multi-specialty practices and emergency clinics the use of in-house laboratory testing has also greatly increased. Everything from simple CBC and biochemistry analyzers to instruments that measure serum electrolytes, blood gases, hormone levels and pancreatic malfunction are on the market. And while some estimate that a large percentage of veterinary hospitals have one or more in-house lab machines, at least half of those machines in use are thought to be antiquated. "There is a wide range of age in in-house analyzers in the field today,” said Michael Solomon, director of business development for Abaxis North America Animal Health headquartered in Union City, Calif. "I estimate that greater than 90 percent of clinics have at least some type of in-house analyzer that they may use in various situations. Of these, at least 50 percent are older analyzers that may lack some of the features and benefits of the newer generation of in-house equipment.” Deciding whether an in-house lab system is outdated depends on a number of factors. "The definition of ‘antiquated’ could simply be stated as ‘old-fashioned’ or ‘outdated’—but what does this really mean?” said Casey Etter, senior marketing manager for Idexx Laboratories in Westbrook, Maine. "Many practices use a technology that has been in existence for a very long time and still performs, is accurate and has had regular software updates. Therefore it is never outdated.” On the other hand, said Etter, when it comes to technology such as in-house chemistry or hematology analyzers, functionality may not be enough. "Technology has changed at a rapid pace in the last decade, and it is important for practices to stay current and educated on new capabilities available to them,” Etter said. "Therefore, the definition of ‘antiquated’ technology really depends on the practice’s needs.” Frederick H. Drazner, DVM, Dipl. ACVIM, is chief of staff at Animal Specialty Services of Cook County in Des Plaines, Ill. He said that any in-house analyzer older than six or seven years is probably outdated. However, the answer to "How old is too old?” may be more complicated. "The answer lies in instruments’ key components: accuracy, serviceability, technology and comparability to the reference lab,” said Etter. "If the vendor is able to keep the instrument fresh and support all of these key components, then the instrument is never ‘too old.’” In some cases, in-house lab manufacturers may fall short in one of these areas. "Then it is time to consider upgrading to a new system that can meet those needs,” Etter said. Consider the Partner There are also cases in which a company requires an upgrade because its has launched new hardware, which is why Etter said it is important for practitioners to consider the company they partner with as well as its philosophies on upgrades. "It should be an ‘inspire, not require’ mentality,” Etter said. Solomon agrees that choosing a vendor is so key that brand loyalty has become a large part of the equation. "If the older technology has served the clinic well, the customer service has been good, and the financials of running the instrument have been in the clinic’s favor, the clinic will most likely stay with the current brand,” Soloman said. That can make it even more difficult for competitors to displace the in-house equipment. There are ways around that obstacle for certain companies, though. "Some nationally established laboratories will provide the private practitioner with attractive incentives for the purchase of in-house analyzers if [the practitioner] contracts with that company to use its reference facility (including cultures and sensitivity testing, cytology and histopathology),” Dr. Drazner said. Cost-effectiveness Clinics have their own obstacles to overcome when equipment needs upgrading or replacing. And several factors weigh on the minds of practice owners considering an investment in new analyzer technologies. "In single-person practices with smaller caseloads that tend to concentrate on preventive medicine and surgery, the need to be equipped with brand-new state-of-the art analyzers is not cost effective,” Drazner said. "These practices rely upon older analyzers or may send the vast majority of their samples to reference laboratories.” He also said that the economic status of a clinic’s neighborhood, how educated clientele are and the ability of a hospital staff to educate pet owners about how laboratory testing helps more quickly and accurately diagnose patients are other challenges facing clinics. Potential for ROI Solomon has a different take. He said that it’s about whether a practice owner understands the potential for return on investment with more current technology. "In other words, the clinic’s ability to run a few new analytes or a few more tests per hour is often worth the investment,” Solomon said. But how many more tests a machine can run is just one piece of the puzzle. About that lab... Is your in-house laboratory behind the times? Casey Etter of Idexx Laboratories in Westbrook, Maine, recommends answering these questions to decide. * Is the instrument still reliable? * Does it provide accurate results? * Do the results mirror the most current technology provided by the reference lab? * Is it still supported and serviceable? * Can it keep up with the technology in other areas of the practice? If the answer to these questions is "Yes,” then regardless of how old the system may be, it is still current. "If the answer to any of these questions is ‘No,’ then you have an antiquated system,” Etter said. "Look for analyzers that can provide you with accurate results as well as maintain the flow of the information,” Etter said. "For an example, would you sign a five-year contract for a cell phone that wasn’t able to connect to the Internet or have updates easily available to you? To manage information, provide efficiencies and client communication, analyzers must be able to talk back and forth with your practice management system and receive remote service.” Also integral to choosing the right equipment are quality control measures to ensure practitioners are getting consistently accurate data. "Most in-house instruments need some kind of quality control to be run at some time interval in order to achieve accurate results,” Solomon said. Likewise, Idexx analyzers have extensive quality-control measures. Etter said that with independent quality control, factory auto-calibration ability, proactive monitoring of instrument performance and regular software updates and support through Idexx Smart Service, customers have assurance in their results. "Internally, systems must be built to the highest standards with checks and balances monitoring all activity,” Etter said. "Advanced high-precision hardware that detects and accounts for sample quality matched with optical reflectance sensors, temperature stability thermistors and on-board cleanliness references prove internal systems are working. In addition to internal monitoring, external quality control is key to trusting results.” Updates, Upgrades Drazner said he’ll have a better idea of the new technologies and improvements to existing in-house systems after he attends the American College of Veterinary Internal Medicine Forum in Seattle in June, but he has a wish list for manufacturers. "My wish list would include improvements in measuring blood ammonia, blood gases and serum bile acids,” he said. Idexx and Abaxis offer new products and new features of existing products this year. "Abaxis has recently launched the new version of the VetScan HM5 hematology analyzer,” Solomon said. It now includes touch-screen technology and updated user interface. In addition, Abaxis Veterinary Reference Laboratory recently launched two new panels, the Canine Obesity Panel and the Mast Cell Tumor Diagnostic Panel. Abaxis also plans to launch a rapid Ehrlichia and Anaplasma test to add to the already released Canine Heartworm and Lyme tests. This year from Idexx, practitioners will see more increased menu and software enhancements, including increased integration and efficiency, Etter said. "We are always expanding our diagnostic menu and capabilities, such as the addition of banded neutrophils to our ProCyte Hematology Analyzer last year, and the addition of PHBR to our Catalyst menu,” Etter said.
