Curriculum Vitae Personal Data Miswar Fattah M Si

Curriculum Vitae Personal Data Miswar Fattah, M. Si Makassar, 6 Juni 1978 Education 1997 : SMAK Depkes Makassar 2002 : Chemistry - University of Hasanuddin 2006 : Clinical Chemistry, Biomedic- University of Hasanuddin Current position Research & Esoteric laboratory Head, Prodia Clinical Laboratory Molecular Diagnostic Scientist, R&D Prodia Clinical Laboratory Scientific division of Molecular Diagnostic , Indonesian Association for Clinical Chemistry International Relationship departemen PATELKI

Otomatization & Expert system in Laboratory Medicine Miswar Fattah, Msi TOT Bandung , 27 November 2011 PATELKI

Introduction Term of automation Concept automation in clinical laboratory medicine : a history Current concept in automation of laboratory medicine Impact automation in medical technologist & Regulation PATELKI

Automation is the use of control systems and information technologies to reduce the need for human work in the production of goods and services Laboratory automation is the use of instrument and specimen processing equipment to perform clinical assay with only minimal involvement the technologist PATELKI

Why automation PATELKI

Why automation Reduce human error Safety decrease laboratory costs improve turnaround time increase productivity Run more tests Test in fewer sites Operate with fewer instruments. Retain lower operating costs. Employ relatively less skilled labor. Use more automation in a paperless environment PATELKI

Adding Value to Lab Tests Through Automation Lab Test • Faster TOT • Accuracy, Precision, Safety Add information value • Autovalidation • Trending Effecting change using lab results • Lifestyle changes • Selection of Lab Test Autovalidation Trending Life Style Adjustments Appropriate Therapeutics therapeutics PATELKI 7

History In the early years of clinical laboratory science--the 1920 s, 1930 s, and 1940 s-tests and assays were performed manually evolution of clinical laboratory automation began in the late 1950 s with the development of flame photometry and peripheral blood cell analysis PATELKI

Rapid system of microchemical analysis for the clinical laboratory PATELKI Clin Chem 1958; 4: 127– 41

History the Coulter Counter in 1957 revolutionized the counting of a variety of peripheral blood cells, including red blood cells and leukocytes PATELKI Wallace H Coulter

First Autoanalyzer Technicon Autoanalyzer II (AAII) system. Peristaltic Pump Module Auto. Analyzer is an automated analyzer using a special flow technique named "continuous flow analysis (CFA)" first made by the Technicon Corporation. The instrument was invented 1957 by Leonard Skeggs, Ph. D and commercialized by Jack Whitehead's Technicon Corporation. The first applications were for clinical analysis, but methods for industrial analysis soon followed. PATELKI

Multiple automatic sequential analysis The first multichannel analyzer to perform eight determinations simultaneously is described. The analyzer records directly on calibrated paper, providing an “immediately usable form”. One operator can perform 960 individual tests per day, equal to the output expected person in a month with manual techniques PATELKI Clin. Chem 1964; 10: 918 – 36

A multichannel continuous flow analyzer. Multichannel analyzers allow 10 simultaneous determinations on 1 m. L of serum at a rate of 60 specimens per hour PATELKI Clin Chem 1966; 12: 120 – 36

History First fully automated in clinical laboratory implement in Kochi Medical School by Masahide Sasaki (Automation Pioneer ). Modular system PATELKI

teknologi yang mendukung otomasi Robotik / mekanik Fluidic Metode Track Sensor Komputer Software Barcode PATELKI

Robotic Sample Transport gantry robot The SCARA (Selective Compliance Assembly Robot Arm) PATELKI

Fluidic (Flow sample & Reagent) Continuous Flow Analyzer • Tubing flow of reagents and patients samples Flow Injection Analyzer • Centrifuge force to mix sample and reagents Dialyzer module • Separate testing cuvets for each test and sample • Random and/or irregular access PATELKI

CONTINUOUS FLOW In continuous flow analyzers, • samples were aspirated into tubing to introduce samples into a sample holder, • bring in reagent, • create a chemical reaction, • and then pump the chromagen solution into a flow-through cuvette for spectrophotometric analysis. PATELKI

Continuous Flow • The major drawbacks that contributed to the eventual demise of traditional continuous-flow analyzers in the marketplace were significant carry-over problems and wasteful use of continuously flowing reagents. PATELKI

Continuous Flow Continuous flow is also used in some spectrophotometric instruments in which the chemical reaction occurs in one reaction channel and then is rinsed out and reused for the next sample, which may be an entirely different chemical reaction. PATELKI

Miniaturisation PATELKI

Centrifugal Analyzers Discrete aliquots of specimens and reagents are pipetted into discrete chambers in a rotor The specimens are subsequently analyzed in parallel by spinning the rotor and using the resultant centrifugal force to simultaneously transfer and mix aliquots of specimens and reagents into radially located cuvets. The rotary motion is then used to move the cuvets through the optical path of an optical system PATELKI

Discrete analyzers Discrete analysis is the separation of each sample and accompanying reagents in a separate container. Discrete analyzers have the capability of running multiple tests on one sample at a time or multiple samples one test at a time. They are the most popular and versatile analyzers and have almost completely replaced continuous-flow and centrifugal analyzers. PATELKI

Discrete Analyzers Sample reactions are kept discrete through the use of separate reaction cuvettes, cells, slides, or wells that are disposed of following chemical analysis. This keeps sample and reaction carryover to a minimum but increases the cost per test due to disposable products. PATELKI

Hitachi 902 Analyzer PATELKI

Detection technologies & Method Fluorescence Detection Technologies • • Fluorescence Polarization (FP) • Fluorescence Correlation Spectroscopy (FCS) • Fluorescence Resonance Energy Transfer (FRET) • Dissociation-enhanced lanthanide fluoroimmunoassay (DELFIA) • Homogenous Time Resolved Fluorescence (HTRF) • LANCE Ultra™ • Fluorescence Intensity (FLINT) Fluorescence Lifetime Analysis (FLA) Luminescence Detection Technologies • • Flash Luminescence • Alpha. Screen™ • Electrochemiluminescence (ECL) • Glow Luminescence Bioluminescence Resonance Energy Transfer (BRET) Radiometric Detection Technologies • • Flash. Plates® • Scintillation Proximity Assays (SPA) • Filter Binding Assays LEADseeker™ Absorbance Detection Technologies Other Technologies PATELKI

Automatic Identification and Data Capture Laboratory use • Identification of sample-containing vessels: • Identification of reagent-containing vessels: • Identification of equipment: • Identification of laboratory personnel: • Entry of instructions or data: Technology • bar codes, • Radio Frequency Identification (RFID), • biometrics, • magnetic stripes, • Optical Character Recognition (OCR), • smart cards, and voice recognition. PATELKI

Tigris DTS Internal Automation Reagent lot numbers are automatically linked to results Bar codes of randomly loaded samples are read Overview Tubes are sampled through pierceable caps PATELKI Pictures and video from Gen-Probe Paramagnetic microparticle capture and detection 28

Specimen Conveyance Sneaker net Mobile robotics Conveyor belt Accelerated conveyor belt PATELKI 29

Mobile Robot Conveyance PATELKI 30

Phlebotomy Ball and Socket Closure Device The Lasette (Cell Robotics, Albuquerque) PATELKI 31

Sample Labeling Efficiencies Bar coding at the pointof-phlebotomy B-D id 2 D vs. 1 D bar codes • Reduce the number of computer interfaces • Self directing specimens RFID • Current costs of RFID around 25 cents PATELKI 32

Phlebotomy Tray Preparation BC-ROBO – mini 20 PATELKI Single tray system BC-ROBO – mini 40 Multi-tray system 33

Cakupan otomasi di lab klinik Hematologi Kimia klinik Immunologi Analisa berbasis sel Mikrobiologi Molekular diagnostik dll PATELKI

Laboratory Automation Conveyor Distribution Technologist Distribution Picture of the UVA lab here Sonic Healthcare Sydney Australia PATELKI The University of Virginia Clinical Laboratory Charlottesville, VA 35

Automated work cell A special case of an integrated system. Preconfigured, often available commercially offthe-shelf as a standard system for a given type of or class of sample processing Automated workstation capable of performing a limited set of Laboratory Unit Operations (LUO's) (as few as two) in an automated mode, coordinated by a workstation controlle PATELKI

Leonard T. Skeggs PATELKI

Automated Storage and Retrieval PATELKI IDS, Japan BIOPHILE, Inc. , Charlottesville, VA 38

Automation in Microbiology PATELKI

bio. Merieux’s PREVI Isola is a system for automating routine agar plate inoculation. It maximizes colony isolation, eliminates risks, and standardizes plate inoculation and results in a fully automated approach PATELKI

Self-Directed Health Care Genomic Screen for Chronic Disease Data Interpretation Smart House Monitoring Early Warning of Disease Onset Proteomic Assessment Personal Health Improvement Health Intervention PATELKI 41

Flow Cytometry Now & Future In vivo Cytometry-A Next Generation flow cytometry is a method of counting PATELKI thousands of cells per second Diagnostic Tool. A Real-time health monitoring

Nanoautomation PATELKI

Standarisasi Automasi · AUTO 1—Specimen Container/Specimen Carrier contains standards for the design and manufacture of specimen containers and carriers used for collecting and processing samples, such as blood and urine, for testing on laboratory automation systems. · AUTO 2—Bar Codes for Specimen Container Identification provides specifications for linear barcodes on specimen containers for use on laboratory automation systems. · AUTO 3—Communications with Automated Systems facilitates accurate and timely electronic exchange of data and information among automated instruments, laboratory automation systems, and other information systems. · AUTO 4—Systems Operational Requirements, Characteristics, and Informational Elements provides standards of interest to operators for display of system status information such as specimen location, reagent supply, and warnings and alerts to support laboratory automation operations. · AUTO 5—Electromechanical Interfaces provides guidance for the standardization of electromechanical interfaces between instruments and/or specimen processing and handling devices and automation systems in the automated laboratory. PATELKI

Conclusion Automation of the main chemistry analyzers, including immunoassay and linking them together with preanalytical and postanalytical automation to give total laboratory automation has given predictability to result availability PATELKI