I installed and validated our Echo over two years ago and overall the Echo is a good instrument, the mechanical operation is relatively simple with quick and easy maintenance. For facilities with moderate to large volumes of routine testing it does free up a lot of bench time. The patient data organization is cumbersome for facilities that are not computerized. However, when interfaced with a Blood Bank computer system the Echo will download worklists and upload patient test results fairly seamlessly. The functionality of the analyzer is also somewhat limited to ABO, RH, Antibody Screen, IgG DAT, and Antibody ID panels. While it is capable of running other functions such as forward typing of donor units and crossmatch testing these are more complicated and time consuming than manual testing. One of the best cost effective features that I have found is that many of Immucor's tube typing reagents are used on the Echo as well, reducing the number of reagents need to maintain two methods. We did have some issues with validation. The analyzer will only detect IgG antibodies, which led to us removing the crossmatch option from our testing due to incompatible blood types being reported as compatible. This also prevents the analyzer from detecting cold reactive IgM antibodies, which could be clinically significant in surgical cases where the body temperature would be lowered. The much increased sensitivity for IgG reactivity can cause problems when starting out as you may notice and increase of positive antibody screens with no identifiable specificity when tested against ID panels. We have found through experience that many of these patients with non-specific reactivity actually develop identifiable antibodies when tested at a later date, leading us to believe that the Echo may be picking up very low titers of certain antibodies. I would recommend this analyzer for any facility with moderate to high volume of routine testing that could be batched, and had the ability to have an interfaced computer system. If you have any questions fell free to contact me directly.