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Biochemistry Instruments And Reagents – Vital In Any Tertiary Care Hospital

The biochemistry/immunochemistry instruments and reagents are integral part of lab equipment in any tertiary care hospital. For a hospital with high occupancy at out-patient and in-patient level and busy operating rooms, the tests like sugar, cholesterol, protein, enzyme, etc. are very much an integral part of clinical decision for all clinicians. The requirement of clinicians/treating consultants is that tests should be done within defined turnaround time, should be reliable, and co-relate with clinical diagnosis. The following technical features should be considered while deciding on biochemistry/immunochemistry instruments and reagents:

  • The scope of clinical tests and profiles of equipment should match to the services provided by hospital.
  • Throughput is one of the major considerations when procuring equipment. Number of tests per hour should be in line with current and future hospital workload and not whatever is being pushed by equipment sales team.
    Right from drawing blood to reporting, total sample automatic transfer system of workflow is desired.
  • Number of photometric modules and ISE modules including assay measurement principles like end point, kinetic delta.
  • Sample tray capacity and sample size.
  • Sample volume and reagent volume.
  • Fully automated random access/STAT sample priority. Critical test chemistries to be done within one minute.
  • Reagent type, automatic level sensing reagent delivery, and on board reagent storage.
  • Auto calibration and its frequency.
  • Integrated bar code reader with LIS interface and supporting remote maintenance.
  • Type of optical system and light source.
  • The features like automatic clot detection, automatic collision protection, and automatic checking of serum indices.
  • Wavelengths it can support: single/double like 340 nm, 480 nm, 800 nm.
  • Technician friendly operation including audio and visual prompt alarm, like unusual test results.
  • The space availability in the laboratory.

The acquiring of technology from service providers evaluate costing based on test accuracy and reliability, QC and calibration methods and frequency, stat time, start-up procedures and time, consumable cost, maintenance cost, and more importantly cost per reportable result. The hospital can decide on any of the options, i.e., outright purchase, reagent contract, lease based on capital cost, and operating cost (reagent, consumable, maintenance, and salary). Outright purchase would be required resulting in the hospital going through a typically long capital equipment approval process, and the technology may become obsolete before hospital have surpassed the useful life.

The free equipment is a misunderstanding for reagent rental contract. While going for reagent rental, all the costs included and excluded in that number need to be closely reviewed. The advantages of a reagent rental are that a monthly payment to service provider may be easier to budget for, there is no capital investment in advance, the hospital procures the equipment quickly, and it is easy to upgrade to the newer technology/model of equipment. The disadvantages relate more to the hidden costs of this pricing structure like controls and consumables. There are penalties for low volume than minimum guarantee mentioned in contract. The hospital would require accurate volume estimations, otherwise the costs would continue to add up. All reagents from the service provider are on a cost-per test or cost-per-reportable-test basis based on the number and type of tests that will be performed per year and equipment and service costs.

In a cost per reportable report agreement, the pricing structure is similar to that of the reagent rental, except here the hospital pays a set price per patient result obtained using the equipment. The cost of the equipment and service are typically added into the cost per test. The biochemistry/immunochemistry instruments are undoubtedly vital equipment in hospital from patient point of view and care is to be taken to control operating cost, without compromising on high accuracy and precision of test results.

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