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Like many organizations, the labs at TriHealth, a not-for-profit health system serving the greater Cincinnati area, have experienced a great deal of growth in recent years. So when it came time to upgrade aging equipment, the TriHealth team took the opportunity to go beyond simply replacing instruments—and, instead, found the right solutions and workflows to continue supporting growth into the future.
The Challenge: Non-Standardized Operations Proved Difficult to Scale
TriHealth had a number of labs across its system with varying equipment, test menus, and workflows depending on the patient populations served by each. As the system has grown in recent years, these differences between labs began to pose challenges, including:
- Different reference ranges
- No reagent sharing, causing supply chain challenges
- Issues with technician availability and troubleshooting
- Non-standardized training across analyzers
The Solution: Standardizing With Excellence in Automation
The team knew standardization could help address all these issues, so they set out to evaluate new automation solutions with the goal of achieving common reference ranges, using standardized reagents, with the same training—all from a single vendor that could address the organization’s needs and support continued growth.
“Laying out the goals allowed us to focus on the important aspects of what each vendor could offer,” explains Brittany Bedel, Director, Laboratory Operations at TriHealth. “Ultimately, we were able to select one vendor we knew would help us standardize and streamline workflows in all our labs.”
Proven Results
TriHealth selected the DxA 5000 Total Lab Automation System with REMISOL Advance Middleware. With standardized automation and middleware across its labs, TriHealth has been able to reduce manual steps, reduce turnaround times, and support rising test volumes with the same number of full-time employees.
Reducing Manual Steps
After moving to the DxA 5000 solution, Bethesda North, a TriHealth flagship hospital, was able to reduce manual process steps from 28 to 16—a 43% reduction.
“With this improvement in efficiency, our techs can now manage multiple benches,” notes Bedel. “[This] helps with staffing and ultimately helps [us] manage an increasing workload, allowing us to expand our test menu.”
Reducing Turnaround Times
The new automation solution also helped TriHealth significantly reduce turnaround times, which is critical to patient care. Pre- and post-testing at flagship hospitals showed as much as a 60% reduction in turnaround times and 15% reduction in standard deviation of result times.
“Having a more robust automation system has allowed us to provide more consistent and reliable resulting times throughout our labs,” says Brian Twarek, Laboratory Manager, TriHealth. “In the lab, we’re limited on factors we can control to move result times. If a test has a 15- or 20-minute incubation time, there is nothing we can really do to speed that up. Where we do have the ability to make improvements is the time it takes to get that specimen to the analyzer so it can be sampled—and this is really where automation has been able to drastically increase the efficiency of our labs.”
The TriHealth team has also been able to handle STAT testing more quickly. Since implementing the DxA 5000 system, the team has been able to reliably turn around 95% of STAT testing within their goal TAT of 45 minutes.
“This has allowed us to increase the amount of STAT testing reported out by about 15% over the last five years,” notes Twarek. “The ability of the DxA 5000 system to prioritize the processing and testing of STAT samples across our departments has been really instrumental in our ability to not only meet, but exceed, our resulting goals. And these numbers become even more impressive when we factor in the significant increases in testing volumes over that period of time.”
Improving Productivity With Similar FTE Counts
Automation also helped TriHealth handle increasing test volumes without needing to add FTEs. Between 2019 and 2024, testing volume at the Bethesda North flagship hospital increased from 1.5M to 2.1M tests—but with the right combination of automation, middleware, and standardization, the lab was able to handle the increase with approximately the same number of FTEs to support testing.
“We were able to do this, in large part, due to instrument standardization, the new automation system, and the use of REMISOL middleware,” explains Bedel. “The automation system allows more hands-off time for our techs, so they can focus on other priorities, whether that be releasing test results, running other tests, troubleshooting, etc… Less hands-on time for techs gives them freedom to do other things.”
Customizing Rules With Middleware
In addition to the DxA 5000 Automation System, TriHealth found great value in the REMISOL Advance Middleware solution. To date, TriHealth has taken advantage of customizable rules to address several unique use cases. For example:
- For cancer institute patients, physicians wanted to be notified when liver enzymes were elevated. The laboratory team created a rule in REMISOL Advance that stopped all ASTs and ALTs greater than 400 with an order location of “Infusion,” prompting techs to call the clinician before releasing the results.
- When a physician questioned phosphorous results in NICU patients, the lab team immediately confirmed the results were accurate. However, for added quality control, they also created a rule in REMISOL Advance directing techs to re-spin and rerun a sample if the result is less than 3 and the patient age is less than 3 days.
“REMISOL middleware has helped tremendously with continuity of care,” comments Bedel. “It lets us create rules that allow us to react, make changes quickly, and deploy them quickly across the system to all techs.”
Leveraging Advantaged Workflows With Scalable Automation
TriHealth’s story is another powerful example of our philosophy of Advantaged Workflows in action. With scalable instrumentation, optimized workflows, and integrated middleware, the organization found the right solutions to support its unique needs and growth trajectory. Get to know Advantaged Workflows here.
Watch the Full Webinar to Learn More
TriHealth recently shared their full story through an ADLM webinar. Watch it on demand any time to learn even more ways automation has helped TriHealth’s labs support growth and optimize patient care—including a helpful vendor checklist designed to support them as they continue expanding their network and testing menu options.
