• Iizuka Hospital
  • Kochi Medical School Hospital
  • The Fraternity Memorial Hospital
  • Gifu University Hospital
  • Kitano Hospital
  • Iwate Medical University Hospital
  • Yamaguchi University Hospital
  • Kurashiki Central Hospital
  • Goto Central Hospital
  • Kishiwada City Hospital
  • Aso Iizuka Hospital
  • Kochi Medical School

Laboratory Reports

Kochi Medical School Hospital (1)

※Name of facility and titles are from the time of visit.

The Legendary "Belt-Line System"

I. Preface

Professor & Former Professor & Chief Technologist
Prof. Sugiura / Former Prof. Sasaki /
Chief Technologist Nishida

In 1981, the laboratory system of Kochi Medical School was the first attempt in the world to connect multiple number of analyzers by a transportation system and combine them with LIS (Laboratory Information System) constructing an Integrated Automation System. This was implemented by former Professor Sasaki and his team. The greatest feature of this historical LAS, the so called “Belt-Line System” was that the system was designed and built, constructed, and operated as well as maintained by the laboratory technologists themselves. This is probably the one and only system in Japan with such features. In honor of this legendary system and the team that realized it, the first laboratory report features Kochi Medical School Hospital.

II. System Overview

Its system is based on the overhead multiple-track line to the respective destination. Two identical analyzers are installed as much as possible.
Thanks to this system concept as well as technical capabilities that allow partial modification at any time. LAS has been working since 1981 even though it experienced many amendments or expansions as well as renewals of analyzers.

LAS

LAS

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New LAS(1)

New LAS(1)

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New LAS(2)

New LAS(2)

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It is one of the oldest LIS that had been operated by LAN before and the name of Client-Server system came to be common through IBM-S/1 system and the users covered the work themselves from design to maintenance. Even now, advanced computing technologies such as C/S constructed software, diagnosis support engine or new web construction are going to be adopted.

III. Flow of Specimen

■ Sample Reception and Outpatient Blood Sampling

Sign

“Please notify us if your wait is longer than 10 minutes.” This sign no longer surprises anyone but the hospital’s “we will not make you wait” attitude was the epitome of service provided to patients in the early 80s. This also represented the laboratory’s clear concept towards installation of a newly constructed system. This is where patient identification, preparation of labels, blood collection, centrifugation and de-capping are done.

Chief Technologist Nishida:
Even without the automation of centrifugation, positive effects of automation are seen such as reduced sample volumes, accurate sampling, and return on investment not to mention speedier operations. This is a place where technologists and nurses cooperate with each other and work together.

Outpatient Blood Sampling

■ Sorting / Auto-Line Selection

Sorting / Auto-Line Selection

Each sample on a rack is set on the line by the robotic carrying system, of which destination is determined by the test order read from the barcode. The rack on the belt line moves up to the overhead line that carries the samples to each destination in the laboratory.

■ Overhead Line / Elevator

Once a rack reaches its destination by the overhead belt-line, it is carried down to the analyzers by the elevator.
Head Technologist Kataoka:
This elevator is controlled by hand-made 8 bit CPU hard and soft ware. When we first developed this, it was controlled by hardware due to lack of funding.

Overhead Line / Elevator

■ Clinical Chemistry Line / Glucose Analysis

Clinical Chemistry Line / Glucose Analysis

GA02U (A&T) is installed. One computer integrates the LIS on-line terminal and the console of analyzers.
Head Technologist Kataoka:
This integrated line was the first to indicate the next generation LAS. Applications for conventional analyzers were made exclusively for each analyzer so they could not be controlled or operated by LIS terminal. The standardization of LAS communication will be common in the next generation.

■ Clinical Chemistry Line / Clinical Chemistry Analysis (1)

生化学検査ライン/生化学分析(1)

Multiple Hitachi 7350 instruments are installed as the main analyzers. Because this instrument loads 5 sample racks, a dummy rack is used to accommodate the belt-line designed for 10 sample racks. The dummy rack is set apart at the junction before the rack goes into the analyzer.
Senior Technologist Ogura:
We wouldn’t have had to do such an absurd thing if the racks were standardized or the analyzer had external sampling.

■ Clinical Chemistry Line / Clinical Chemistry Analysis (2)

The sub instrument is Hitachi 7070 which is also installed in multiple numbers. The analyzer was easily connected to the transportation system because of its external sampling method.

Clinical Chemistry Line / Clinical Chemistry Analysis(2)

■ LAS Connection of Electrophoresis Equipment by the Multijoint Robot

LAS Connection of Electrophoresis Equipment

Since the specification of the analyzer did not correspond to the transportation system, they were obliged to connect it by using a robotic hand.

■ Blood Testing Line

Blood Testing Line

Ahead of the descending elevator of the blood testing line Omron’s blood imaging system is connected to Sysmex’s HST transportation system.

■ Electrolyte Testing Line

Beckman Coulter’s ASTRA is still working today since measurement including bicarbonate is regarded as very important due to their strong policy on acid-base equilibrium.

Electrolyte Testing Line

■ Infectious Disease Testing by a Robotic Hand

Infectious Disease Testing by a Robotic Hand

This is one of the most innovative system. After inoculation bacteria, total automated medical sensitivity test is performed and the growth inhibiting state of bacteria in each antibiotic are reported in a graph.
Vice Chief Technologist Sugihara:
Since we are dealing with living matters, we need to secure a clean environment and cannot turn the system off for any problems that may occur. It’s a lot of work!

IV. Birthplace of the Laboratory Automation

■ In-yard Vehicle Transportation (Nin-kun and Tai-chan)

They are the first in-yard vehicles in the Japanese laboratories. They have been running since 1985.

In-yard Vehicle Transportation

■ Workshop

Workshop

Here is a complete workshop equipped with a drilling machine, lathe, milling machine, etc. Homemade machines and control systems were born here. (Figure in photo: Former Professor Sasaki)

■ Development Staff

Development Staff

Senior Technologist Ogura / Vice-chief Sugihara / Technologist Kataoka

■ Computer Room

Computer Room

The “Belt-Line System” is a computerized system as well as mechanical system. This was the first laboratory in Japan to use 16M/IBM token ring LAN. By 1986, they had C/S system with Omninet-LAN implemented and in operation, always being ahead of the time in computer technology. Even now, they are tackling the data mining system which used data warehouse that integrated dispersed data bases. (Photo: new servers)
Senior Technologist Kataoka: There is no end in building systems.

■ Belt line Start Area (Main sample testing section)

Prof. Sugiura:
As clinical testing is at a turning point, we need to evolve to the next step with a new way of thinking based on the ethos and technology Dr. Sasaki established. Also, standardization and globalization utilizing research achievements will become an important agenda.

Belt line Start Area

Special thanks to Prof. Sugiura, Dr. Sasaki, Mr. Nishida and the laboratory staff of Kochi Medical School Hospital.