FlexLab™ X at Hospital Clinic of Barcelona: First world wide eXperience

Discover the first worldwide experience with FlexLab™ X at Hospital Clinic of Barcelona in this exclusive webinar. Dr. José Luis Bedini shares how one of Spain’s leading university hospitals successfully implemented Inpeco’s next-generation FlexLab™ X total laboratory automation system in its high-volume core laboratory. Learn how the team managed a complex transition from the previous automation track while maintaining full operations, and how FlexLab™ X is improving workflow efficiency, flexibility, and total testing process automation.

Webinar Transcript:

Good morning. First of all, I would like to thank Inpeco and Pinnacles for inviting me to share our experience with my Chinese colleagues. It is a pleasure for me to be here today with you to explain the first installation worldwide of the FlexLab™ X, the new automation track developed by Inpeco. Here at the bottom of the slide you can see my email address jlbedini@clinic.cat. So please feel free to send me an email if you need anything else from me after my presentation. I will be more than happy to reply your questions.

I want to start my presentation introducing to all of you my hospital. Hospital clinic in Barcelona. It’s a university hospital. It has the maximum complexity of hospitals in Spain, the third level and is located right in the middle of the city of Barcelona.

We take care as a community hospital of more or less 600,000 people. And the hospital includes two other sites. Hospital Platò and Hospital Maternitat. These are spoke sites that have a small laboratory, but they send us the rest of the activity to be performed at the main hub site at Clinic Barcelona. These are images of the hospital. Here you can see the Villarroel Campus, the main site. It’s a very old building that was built by the end of the 19th century. This is Maternitat campus, one of the spoke sites. And this is Platò Campus. The other spoke site. More or less, they are for three kilometers in different directions from the main hub site at Barcelona. Here you can see, as I mentioned before, that we are located right in the middle of the city of Barcelona. The hospital is this green area that will be highlighted right now, and the building in the middle that will be highlighted in yellow is the University of Barcelona, where many of us we are also professors of medicine.
I want to share in the next coming slides some data about the activity of the hospital in the year 2024.

• Here you can see the number of beds, including the three sites around 900 beds.
• The number of admissions per year.
• Outpatient visits per year.
• Emergency room visits.
• Surgical procedures.
• The mean length of stay 6.4 days is the actual mean length of stay.
• The number of employees around 6200 employees.
• The budget over €750 million.

And in the next coming slides, I want you to introduce the, CDB, the Biomedical Diagnostic Center, which is the name that we have provided to our laboratories. Overall, we are more than 490 employees. This is the budget around €60 million per year. This is the total surface occupied by our laboratories. The total activity, including all the labs and the activity performed by the core lab, the main lab where the FlexLab™ X has been installed is around 7.7 million tests per year. That represents roughly 91% of the total activity in our labs.
This slide is to present you, our labs organization. In the year 2001 we created one of the first quality labs in the world, including tests coming from all the lab disciplines clinical Chemistry, Microbiology, Immunology and Anatomical Pathology. Later on in the year 2016, we open the Molecular Biology Core lab. So, following the same idea that we had in the year 2001, we instead of buying NGS, spec mass and molecular biology technology for each lab department, we created a core lab with the same idea that we had in 2001 for the creation of the Clinical Chemistry Core lab. All the labs together, as I mentioned before, we have the name of the central diagnostic or biomedical biomedical diagnostic center.

These are few numbers about the core lab in terms of activity. It works 24/7 because it’s a routine and a STAT laboratory. Every day we manage between 5.400 and 5.700 samples per day, tubes per day. We produce more than 26.000 results per day. More than 7.7 million of results per year. We manage over 200 different tests, including Clinical Chemistry, Immunoassay and Hematology, Hemostasis, and Toxicology. We have 14 routine technicians working from 7 to 9:30 p.m. in overlap shift, and we have three, technicians per shift in the emergency laboratory. And we also have seven staff members, pathologists who are responsible for the validation of their results.

As I mentioned, we have performed the first installation worldwide of FlexLab™ X, and I want to share with you the reasons that we, choose FlexLab™ X as our, total laboratory automation solution in our hospital.

We start with a previous satisfying experience with Inpeco and Siemens, because we work with them for more than ten years with Aptio, you and we were very satisfied yet with the previous experience and the reliability of the Aptio system. Because FlexLab™ X has a flexible design that allows us to adapt, the lab to the changing needs of the of the lab and the hospital labs. We are very dynamic. We need to change quite often our organization. FlexLab™  X is a tool that help us to be very flexible, to adapt ourselves to this changing needs, because we can achieve a space saving and as I mentioned, the hospital is very old and we don’t have a space, so it’s very important to optimize our space because we were expecting improvement in the workflow thanks to the four levels of sample priority that FlexLab™  X can provide to our laboratory,

• because it’s a total laboratory automation solution that allows us to connect analyzer from different vendors. So then it’s totally open to connect analyzes from any company,
• because we will have a full sample traceability in order to check and then in order to know where every single sample is located at every single moment, and to know the further steps that the sample must, must have,
• because we are moving from a total laboratory automation concept to a total testing process automation concept in our hospital, we are also working with ProTube™, which is a system that allows us to totally automatize the pre-analytical phase, reducing in a very significant way the number of errors
• and integrating ProTube™, and FlexLab™ X, we can achieve a better improvement and a better management of the total laboratory process.
• And because we also want the best of both worlds. What do I mean with the best of both worlds?

In fact, we want to keep the same trusted experience that we had with Inpeco working with the Aptio. But we also want a fresh innovation. We need to go further. We need to, improve our daily, quality. So we want to have the best things. We want to have the trusted experience. We want to, work with the same company, but we also do we want to innovate, and we want to introduce new things. That’s why, the presentation of FlexLab™ X for us was a really great news, because, that represents that we can achieve the best of both worlds.

Before starting with installation, the project required more than four months of complex planning. This, was very difficult for us because, the problem is that we need to replace Aptio with FlexLab™ X in the same location we have been working so that was an incredible challenge for us.

There was no option to move the lab to a temporary location, so we need to replace Aptio with FlexLab™ X working at the same location. And I will share with you how we did that. This is how the lab looks like before the replacing. So then this is the Aptio track. First of all, we need to move the staff members. This is the place occupied by the staff offices. We move the staff to a temporary location here, at the usual meeting room, and then we move all the Hematology analyzers from the lab to this temporary location. So we place the routine Hematology and the routine Hemostasis analyzers in this blue box. Then we start with the removing all the elements that you can see here in purple color. We remove the old track, we remove all analyzers, we remove Hematology, and we retain some few analyzes for the future lab.

Then in the next step, we split the laboratory into parts. Here you can see in red an area free of analyzers. There was nothing in installed here. So we start the work to replace the ceiling, the air conditioning, the power supply, the floor. Everything was totally renewed and the rest of the laboratory was totally compressed in the right side of the of the slide here you can see where we placed the Chemistry analyzers and the STAT laboratory, including Chemistry and Hematology. Then here you can see how, it was it was, located. Everything in this in is in this area. When we finish the renovation of the area of the lab, then we switch the spaces. We put all the analyzers in the area renewed, and then we start the renovation of the right side of the laboratory. Here you can see real images of the process.

Here you can see my technicians, my staff members working at the same time in the laboratory, at the same time that the old track was removed. So here you can imagine the challenge for all of them to work in this, difficult conditions. Here you can see other similar images with the old pieces of the Aptio track, while at the same time, my technicians and my staff were working with real samples, producing results for the for the patients in the hospital and for the STAT, so that this was quite a challenge for all of us. In this time lapse video, you can see the whole process. We installed two cameras in one in each side of the lab. So in this video the the image is changing from one side to another. And here you can see how we removed the old analyzers. And we, start the renovation of the, of the track for the installation of the FlexLab™ X.

Here you can see that we have removed some of the pieces of the track and also that the Atellica systems need to be changed in their location. And then we installed, as you can see here, temporary walls to separate the area, that was undergoing the the works from the lab. This is the area that was, firstly, renew. And here you will see in the next coming images, the rest of the lab working at the same time. And here you can see the walls that separated the two spaces. Then we receive a new a Atellica solution. And you will see now the first the first pieces of the track arriving to our laboratory. Here you can see one of the first steps of the of the transition with the two are Atellicas. And now this is the moment that we switch spaces. So from the old lab to the new lab already renew. And then we, were about to close this area for the renovation of this space.

Here you can see how we change the, the, the floor, the air conditioning, the water supply, electricity and everything. And here you will see how we receive the pieces of the new of the new track. As you can imagine, that was a very difficult process because we need to work with the real samples, with the real patients, at the same time that the lab was being installed by Inpeco and Siemens engineers. We took advantage of the renovation of the track to also make changes in all the laboratory to improve the working conditions for the team. And that’s very important for us because we took advantage of that for a better, working space and better environment of the of the system.

This is how the lab looks at the end. You can see in pink the pre-analytical area of the track with all the modules to load the samples, and in blue the analytical part of the track, including hematology systems, coagulation systems, and the Atellica chemistry systems.

The project execution was really complex. But the good thing is that Inpeco, Siemens and Clinic, we worked together as a team.  That was very important because it allowed us to anticipate the go-live date by two weeks. It is quite infrequent that such a complex project was performed in less days than expected. That is result of the working group, of working together the three companies to implement the new system.

This was also quite an important surprise for us because, being the first FlexLab™ X installed in the world, we were very impressed by the level of consistency and effectiveness achieved right from the start. The high market readiness level of course being the first FlexLab™ X in the world, we were expecting to have some issues and problems, but the truth is that the system was very reliable from the very beginning and we had very few problems with that.

As a result of FlexLab™ X, we have been able to make some important achievements and one of them is space optimization. This is the total surface previously occupied by Aptio, and here you can see the space occupied by FlexLab™ X. Meaning that we have been able to achieve a footprint reduction of around 14%.

In terms of the previous track length, the system had 108 meters and now the system has a length of 71 meters, which a total reduction of 37 meters. This is very important because that help us to improve working conditions for all the people in the laboratory and especially because now we have the space available to connect other analyzers in the future while with Aptio there was no space to connect more analyzers. So that means that with the same space, now we have more free space to work in better conditions and also to connect future analyzers in the future.

Another improvement we have achieved is the improved workflow for managing samples with priority. The system has four levels of sample priority, and that help to manage samples in a better way.

There is a significant noise reduction Inpeco claims that there is a 30% noise reduction. This is very important because the labs we work 24/7, and it’s quite complex to work with noise in the lab. In terms of decibels, it is correct is a 30% noise reduction but in terms of noise perception, it is much higher. I really must say that we have totally changed the atmosphere in the lab, which is now more relaxed and quiet. This is one of the things that my technicians, they really appreciate the most.

Other achievements is that we have increased the capacity of the sample storage. Now we can store more than 25,000, tubes. That means 35% more with a similar footprint. That very important because, as I mentioned, we don’t have, a lot of space. The hospital is old and we don’t have a space to grow. And now with the same footprint, we can store 35% samples more. And this is very convenient for us because we can keep, in the storage module, seven, seven days of tubes.

Other important improvements is the bulk input module. Here you can see in the video how this bulk input module is able to manage the samples. The capacity is over 1200 samples per hour. And you can see here the robotic arm picking up the tubes orloading the tubes into the into the track in a very efficient way. It is important to remark and you will see in in the video that the bulk input module can also manage the STAT samples. You will see how here the system is loading this tube but meanwhile if we load here, the STAT sample has been placed before other samples into the track.

Other important achievements is the high level of practicability. Here you can see the software of the system that is very intuitive and interactive. So we can control every single, element, connected to the track from this software that has different ways of presentation. And another important thing is that here you can see one of my technicians working with a tablet that allows her to manage everything from the tablet so she can get close to the analyzer. She can get close to any module connected to the track to make diagnostic movements, to make, fixing of issues. So we have a total flexibility to work with the with the track.
The system has also this color code. So the modules has colored lights indicating the status of the module. Here for example, you can see the bulk input module with purple meaning is stand by it with red, meaning that there is something needs to be to be fixed and blue meaning that is working without problems. Here you can see the input output module, again with different colors, meaning different status of the, of the system. That’s important because from, everywhere you can see the color of the module and you can notice if everything is working properly.
The Flex Lab™ X has a state of the art design that makes the lab beautiful and very comfortable for the for the technicians.
We have an open space and more operational control of the laboratory because the modules are smaller compared to Aptio and compared to other solutions in the market. So we have been able to achieve a better and more comfortable working environment for the technicians. And that’s very important for us that we spent many hours every day in the in the, in the lab.
But it’s also important to remark that we have been able to achieve some improvements regarding the TAT, the turnaround time. In this slide, you can see that before FlexLab™ X was installed in our in our hospital, the percentile 90 for the for the STATs was around 54.5 minutes and now with FlexLab™ X the percentile 90 is 50.2 minutes. That means that we have been able to achieve reduction in the TAT of more than 4.3 minutes. That means a time for a better patient care. And that’s very important. And it is something very remarkable that we have been able to reduce the TAT, just installing the FlexLab™ X.

Some final thoughts, before ending my presentation, is that despite the complexity of the project, the result has been a success. We are very happy with the result of the project from every single point of view, from technology, from instrumentation, from turnaround time, from space, for working conditions that the FlexLab™ X market readiness level was much higher than expected. And this is really important, being the first lab in the world to install Flex lab X is a risk and also opportunity and to be honest, as I mentioned before, the number of issues that we have experience is very, very, very, very small.
We have achieved many benefits and improvements, being workflow optimization, noise reduction, TAT improvement, better working environment, and a space saving, the most relevant. And we in fact, are expecting further improvements, mainly in the workflow area, once we gain more experience customizing the system according to our needs. I must say at this point that we are working together with Inpeco to improve some of the performances of the track in order to achieve even a better workflow in our lab and in all the labs that we will install FlexLab™ X in the future.

And my final thought, technology and automation are important and help us to improve our work and to provide good service to both patients and physicians. But technology and automation, are nothing without people. And this project would not have been possible without the work of the entire and technical and staff team of the core lab. Without the support of the management and the transversal staff of the CDB, without the effort of all the people from all of the people from Inpeco and Siemens, and without the commitment of the infrastructure and I.T Department of the hospital.
And I want like, I would like to end with a quote that, I love is that the “pessimist complains about the win, the optimist expect it to change, and the realist adjusts the sails”. I, I really think that here in Spain and there in China, the labs, we always face challenges. The situation is difficult, all around the globe, especially for the health system. And we people working at the labs, we are very realistic people that we always adjust the sails.
Thank you so much for your attention. And I will be here, to reply any questions that you can have.