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ARUP Expansion to Increase Automation, Standardization and Processing Capacity

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NEW YORK (360Dx) – ARUP Laboratories has broken ground on a new building that is expected to greatly expand existing capacity by adding new automation and a massive increase in space to the company's lab campus.

The new building, called Building 4, will house highly automated processing of all new specimen arriving at ARUP as well as most of the lab's high-volume testing.

"In some ways this will be the center, or the nucleus. Samples will flow into this building and then through the high-volume labs," said ARUP President Andy Theurer in a phone interview. "If it is not a high-volume test, then it will go out to one of the other labs, but all tests will come into this new building. That's the vision operationally."

With 200,000 square feet of space, the four-story building will also greatly add to ARUPs existing capacity. Building 4 will be the largest building in ARUP's Research Park. The other buildings combined total 325,000 feet, according to Theurer.

"We have been struggling with our capacity for some time now," he said. "We have a lot of clients we are working with who want to send us more work and the only restriction we really have is capacity."

While ARUP doesn't release test volumes, Theurer noted that when he joined the company in 1991, there were between 350 and 400 employees. There are now 4,000, and the company hasn't added significant space since an addition was built onto Building 1 in 2003.

In addition to adding capacity, the emphasis on automation in the new building will help ARUP mitigate the lab workforce pressures of the limited number of available lab personnel to staff a growing lab company.

"The growth is greater than the supply of trained professionals, so one of the ways we are trying to combat that is through automation," Theurer said.

The planned highly automated specimen processing area, which is the first arrival point for all new specimens sent to the lab, will be located on the second floor of the new building. The new specimen processing space will be an estimated two to three times larger than the space currently devoted to specimen processing, and it will be designed in a more efficient and more automated manner, according to Jonathan Genzen, section chief of clinical chemistry for ARUP and medical director for the automated core laboratory.

"We anticipate using a lot of overhead conveyors, both for management of boxes, as well as subsequently for transporting specimens once they are logged in," Genzen said.

ARUP currently uses an automated track system for transporting specimens, but the new specimen processing area will implement the automated track for specimen transport over an area with a much larger footprint, according to Genzen.

In the new building, ARUP will also implement track automation for some of the areas that don't currently have it in the existing facility, Genzen said. For example, currently a certain percentage of specimens are not put on the track system, often because they aren't in tubes that fit well on the current track system. Currently, those specimens are taken by cart to what ARUP calls its Sort-to-Light system, where lab employees use barcode readers, each of which have different colors assigned to them. As a lab employee scans a specimen container, the LED display for the bin where the specimen should go lights up in the color of the sorter's scanner. In the new building, the lab plans to implement a track system that would enable specimen to be transported to the Sort-to-Light area on an automated track.

The goal, Genzen said, is at least preanalytically, to move as much specimens as possible automatically.

"We want to minimize the amount of manual handling and maximize the amount of automated tracking and delivery, so that we know where specimens are at any given time," Genzen said.

The emphasis on increasing automation in specimen processing will support an initiative undertaken by ARUP in recent years to achieve Six Sigma level quality in preventing lost lab specimens, he said.

By housing the specimen processing area, the new building will not just support the testing conducted within the building, it will support testing in the other buildings as well, potentially improving efficiency throughout the company, Genzen noted.

"The faster we can get specimens processed, the faster we can test them, so we definitely don't want specimen processing to be a bottleneck," he said.

To enable transportation to other buildings, Building 4 is being designed with connectors to other buildings, so that specimen can be transported from Building 4 to any other building without going outside, according to Theurer. ARUP's buildings in its Research Park are configured in an L shape, and the new building sits roughly in the center-point of the L, giving it easier access for sending tests to labs in the other buildings, he said.

High-volume testing

While Building 4 is being designed for easy access to other buildings, the highest volume testing will be housed within the new building on higher floors. In addition to the automated tracks that transport specimen throughout specimen processing, the second floor will contain automation for vertical flow of specimens to the floors above, Genzen said. The type of vertical conveyance has not yet been determined, as ARUP is still in discussions with potential vendors, but it would most likely be a type of circular ramp, or alternatively, a type of elevator.

The third floor of Building 4 will house high volume chemistry and immunochemistry testing. The testing on the floor will cover a range of specialties but would primarily involve testing of serum, plasma and urine, Genzen noted.

"It's really routine and automated testing. In our language here we would call it automated core lab, automated endocrinology as well as significant immunology testing," he said.

What is unique for ARUP, according to Genzen, is that as an academic reference lab, ARUP sees high volumes in types of testing that would be more esoteric in local settings, such as bile acid testing, hormone testing and certain types of infectious disease serology. That variety presents an automation challenge.

"Because our test menu is so diverse, we really will need to automate and integrate instrumentation from multiple different vendors," Genzen said. "It really is a uniquely challenging and exciting opportunity because we won't be able to support the diversity of testing from a single vendor."

Automation on the floor will include automated rerouting of specimens across instruments so that multiple tests could be performed on a single sample automatically, he said. Genzen declined to identify any potential vendors because equipment contracts are still being negotiated, but he noted that the company is exploring different models for automating the environment, ranging from connecting equipment from multiple different vendors to one large automation system, to having several smaller vendor specific automation environments.

By locating high-volume testing just one floor above specimen processing, the company aims to shorten turnaround time both for large-volume tests and for specimens that may need multiple types of testing. The lab is also able to split samples into separate tubes for simultaneous testing in cases when that is appropriate.

"Ideally because our turnaround times for the third floor in the automated space will be so fast, we are hoping to do as much testing on the third floor as possible before specimens are transported to other areas for testing," he said, adding that testing determinations depend in part on the stability of the sample.

Mass spectrometry consolidation

ARUP is planning for mass spectrometry operations to be consolidated on the building's fourth floor. While not all mass spectrometry will move to the new building, Genzen estimates that ARUP has more than 100 mass spectrometers in use for different types of testing throughout the company, and the new building will allow mass spec testing to be managed more efficiently.

"We do believe we have a significant number of assays in conventional mass spectrometry, endocrinology, and toxicology, where we are operating those instruments in very similar ways and we believe we can achieve a certain degree of efficiency by consolidating those into standardized workflows in a very contiguous space," Genzen said.

The company centralizes some mass spectrometers already in order to run different types of testing on one instrument, but the new building would greatly expand this concept, Theurer said.

"We can simplify testing and standardize the platforms," Theurer said. "The idea is efficiency, simplicity, standardization, and increased quality."

Decisions on which mass spectrometers can be centralized and multiplexed to run different types of testing are being made in careful collaboration with medical directors, Theurer said. Because ARUP is an enterprise of the University of Utah and its department of pathology, the lab has long had mass spectrometers in different specialty areas where diagnostics have been developed, he noted.

"Our roots are in academics and we have some very smart medical directors who develop different types of tests in their areas of expertise. We may have one mass spec in one lab, three in another lab, and two in a third lab," he said. "We knew it would be imperative that we work through this with R&D and medical directors before making any changes operationally."

Building 4 represents years of work for Theurer, who said he first began thinking of adding a new building eight years ago. The other buildings on the Research Park campus had initially been leased from a third party, Theurer said, and the company had difficulty negotiating with the third party to construct the type of building that it wanted, interconnected with the others. As a result, in January of 2017, ARUP bought the other buildings back from the third party to enable the company to have the flexibility to design and build what company officials envisioned. Theurer declined to disclose the cost of that transaction or of the new building.

"We had drawings on this building three or four different times, but we just couldn't get [the leasing company] to work with us," he said. "That's when we decided we just needed to buy the buildings. Once we got those buildings purchased, it moved pretty fast," he said.

The building is scheduled to be completed and ready for occupancy in January of 2020, according to Genzen. Once completed, new equipment will be installed and validated in a phased-in approach, according to Genzen and Theurer. When equipment is up and running in the new building the old equipment will be turned off in the older buildings. After Building 4 is operational, ARUP plans to begin renovating and modernizing the space vacated in the old buildings into larger more modernized lab space for the labs that will remain in those buildings, Theurer noted.