Nuevas teorías de la comunicación de masas

The first question in the series of interviews with the primary supplier staff related to the perceived ‘vision’ for the automated tracking system. This initial question was designed to be an open-ended introduction to begin the conversation and elicited some thought provoking answers as follows:

‘From my perspective the ‘vision’ for the automated technology was to try and incorporate as many of the disciplines and tests within a central laboratory into a common platform. From the company perspective there is more business selling the whole range of tests, but the spin off for the lab it that there is an opportunity for a single process, a single work flow type methodology throughout the lab and the thought of a systemic approach, laboratories could become more productive and potentially slicker’ (S4)

‘I have always thought that the ‘vision’ was “it’s one tube”, “it’s bloods”

and so therefore why should that blood be taken to three different places to book in the same patient, to have their demographics entered into three separate places and then be routed through three separate sets of analysers. I would have thought that that was part of the rationale for it’ (S2).

‘It’s obviously about revenue and I think it's a matter of filling a lab with our kit such that we can put as much of our revenue generated analysers in there as possible. It’s a matter of supplying a package to the customer be it immuno, chemistry and possibly haematology as well, to get as much of our kit in the room as we can to generate as much revenue as possible’. (S5).

Importantly within the context of this research it must be borne in mind that the primary automation supplier was external to the user organisation and as such the decision to offer a ‘multi-disciplinary’ option, whereby the user organisation would purchase the majority of biochemistry and haematology equipment from one primary supplier, was linked to income generation.

With regard to the design intentions of the primary supplier only Manager 1 was in a position to review the history of the technology.

‘Let’s step back so I can tell you how we got involved with it. The

The tracking element of the LSPA system was then not a bespoke piece of equipment; the primary supplier essentially modified a system that was already in commercial operation as highlighted below:

‘So they went out and looked at available technology, they didn’t want to reinvent the wheel, but they looked at things that existed and basically tried to take components that they saw out there and adapt them to the application. The actual track portion of the technology is the direct movement of a track used in a pharmaceutical bottle filling line. So it wasn’t like it was created for the purpose, it was actually adapted and that is one of the reasons that the technology if you look at it is probably more robust looking of all the laboratory systems because of the generation it came from. If you look at some of the newer ones they are not as hefty/heavy looking because “form follows function” sort of thing, they were built specifically to do the job, rather than take an application’ (S1).

The ability to reinvent technology, originally designed for a different albeit similar process, is reminiscent of Lévi-Strauss (1968) ‘bricoleur’. The possibilities contained within an object’s materiality remain limited by ‘the particular history of each piece and by those features, which are already determined by the use for which it was originally intended or the modifications it has undergone for other purposes,’ (Lévi-Strauss, 1968).

According to the primary suppliers, the design of the technology was driven by the needs of the users who were asking for tools to overcome reduced staffing levels including a ‘failure to train or recruit biomedical scientists’ (S1, S3, S4), and as a positive reaction to an aging workforce (S1, S3, S4).

‘They were very concerned about the lack of new medical technologists (biomedical scientists). As you know, especially in the US, the particular field that supplies people to the laboratory is primarily a group of people who are medical technologists that were four year degreed laboratory trained people. The average age of them is now like 55, the demographic is generally female and basically they are not being replaced. Then you got to the point where a lot of these medical technology schools closed and basically the industry was being asked for more tools to help and one of the ways we could help them was basically to provide automation to reduce the labour’ (S1).

From the above quotation it is interesting to note that an apparent reduction in the number of trainee biomedical scientists appears to be a global issue, being as relevant within the USA as it does within the UK as highlighted below:

‘one thing they saw as an opportunity was the apparent lack of people, skill set and new people coming through. In some of our sites, I’m thinking of 15 years ago I was talking to people where they have got eight people in the pathology department and five of them were due to retire in eighteen months. They could not fill any of the trainee posts because of financial reasons. They were posing the question to us 15 years ago and saying OK, we now have 8 people today, tomorrow we will have 5 people, and how will we do the same amount of work with 5 people. I think automation was rising as the laboratories were reporting this problem with staffing levels and pressure on staffing levels (S4).

The introduction of LSPA was then seen as a means of overcoming a shortage of trained scientific staff. In addition this technological response to staff shortages was also seen as a means of reducing human error:

‘Issue number two as you know lean processes, efficiencies are constantly been applied to laboratories today and one of the key aspects is error reduction. Laboratories output is basically results to the physicians and they want them to be error free. As you know any time a human touches anything it’s an opportunity to make a mistake.

So automation also tries to remove the human touches as much as possible and replace it with fail safe automation systems’ (S1).

From a strategic perspective a member of staff from the primary supplier HCS team stated that within the UK the technology was designed to facilitate the development of integrated pathology networks’.

‘My understanding and kind of perception of it is that they could see that there were different levels of integration, consolidation and the development of networks. ‘From feedback that they had that there was a need for some equipment, or some level of automation on the equipment to be able to help the labs or to help the trusts. You could see through this, their vision of becoming more integrated and consolidated’ (S2).

Within this context the introduction of LSPA can be seen as a direct response to the UK Government’s drive to modernise pathology services. The concept of a network is centred on the ability to form a large integrated ‘hub’ laboratory and it can be argued that the introduction of a large LSPA system sends a positive signal to competitors.