In the field of diagnostics, getting to a high-quality, reliable, precise result is critical, but that value is notoriously hard to quantify. It’s relatively easy to understand the costs of getting a diagnostic test wrong: the hospital is burdened with the need to repeat a test or change a treatment course, and the patient may lose time, which is often critically in short supply when treating disease.
But the full costs are harder to substantiate. As diagnostics become more integrated, automated and sophisticated, it’s becoming possible to incorporate prevention into mainstream diagnostics -- identifying key biomarkers early enough to prevent disease onset, in addition to diagnosing and treating existing disease. In both scenarios, quality plays a critical role, but a missed opportunity to prevent disease isn’t as obvious as an erroneous test. Equally difficult to quantify are the economic and human costs associated with diagnostics that take place where water scarcity or water quality issues can impact results.
Extreme Situations Prove a Mainstream Point
Disasters and humanitarian emergencies are extreme situations that can put hospitals out of commission or render them unable to maintain basic life support requirements. Such conditions can be particularly difficult for performing diagnostic tests, and are often the times when accurate and reliable diagnostics are most needed.
• In those situations, power outages, water shortages and the length of time it will take to restore power and clean water have their impact on the lab and its ability to provide accurate test results.
• It can be a nightmare to make decisions about patient care in the wake of disaster. If the laboratory is out of commission due to power or water supply issues, physicians find themselves “flying blind”. Having a reliable power supply alone is not enough because certain assays are very sensitive to water quality. Even subtle changes in water quality caused by bacterial contamination and other factors can lead to erroneous results and the accompanying risks to patient care.
Even in the most controlled hospital and lab situations, results can be compromised by variable water quality resulting from infrastructure or biological issues.
• Most labs use municipal water; while it’s cheap and plentiful, labs must constantly monitor water purification systems to ensure that they are working adequately.
• Water is used to wash patient sample probes, reagent probes, mixing assemblies and cuvettes – all of which come into contact with the patient sample. Any chemical or biological contamination introduced by issues with water quality has the potential to adversely impact assay quality and accuracy.
• What’s worse is that those failures are not always apparent to medical professionals.
Solutions
In vitro diagnostics today influences 66 percent of clinical decision-makingi, and new technologies are critically important to the present and future of diagnostics because they help ensure precision and accuracy. For example, new technologies that reduce or come close to eliminating water use are revolutionizing diagnostics in a number of critical ways:
• From diagnostic nanotechnology to dry slide technology, diagnostics industry advances are making it possible to get accurate results, the first time, without dependence on the quality of water.
• Waterless lab technology can not only eliminate water quality concerns, it can reduce a dependence on water. A typical laboratory with wet chemistry systems can use up to a million liters of water in a yearii; newer dry slide technologies use none.
• Digital chemistry, which is an innovative detection system comprised of a high precision LED illumination source coupled with a digital imaging capture and analysis capability, can capture an imageof a test sample in high pixel quality.
While it doesn’t directly influence patient outcomes, environmental impact is an important consideration.
• It is not just water consumption, but the associated liquid waste comprised of chemicals, detergents and biological material that are untreated, which go down the drain and back into the environment with wet chemistry tests. Dry slide and other technologies greatly decrease liquid waste and pollution.
• With newer, more sustainable dryslides, use of a recyclable container allows for a greatly reduced environmental impact.
The advantages that waterless technology confers in poor working conditions have been recognized by numerous governments around the world. In fact, dryslide technology is used on hospital ships and aircraft carriers during the course of humanitarian missions around the globe.
Conclusion
The cost of the erroneous diagnostic result is high for labs, hospitals and patients. In many cases, it’s simply not necessary, as technology exists to make better, more accurate and more flexible assays available to all.
Today, there is a suite of new technologies that make these improvements possible and many of them eliminate or reduce the use of water. This means less cost to labs ¬-- eliminating the need to provide a complex and costly water filtration system.
For those administrators who are concerned about the cost of increasing quality, consider that spending less on water and water infrastructure lowers these costs and increases quality when dry slide or other reduced-water technology is brought into play. That way, administrators, lab technicians, doctors and – most importantly – patients win.
Footnotes
i Rohr et al. The Value of In Vitro Diagnostic Testing in Medical Practice: A Status Report. PLoS One. 2016; 11(3).
ii Chemistry and immunoassay analyzers for mid- and high-volume laboratories, CAP Today July 2018