Information about Blood Bank Automation for Tango or Echo

[Candybar]

My supervisor is seeking information about compatibility with either the Tango or the Echo and HCLL.

Are they bidirectional? Are you interfaced with your LIS?

Is there a software bug with the Echo that requires you to load only 4 specimens at a time and wait for them to process before adding more?

Can you comment on the instruments reliability and down time issues?

How timely is the service response?

How long does it take to get STAT test results?

How much tech time is spent attending to the instrument? Is it really walk-away? Does it save you about one tech during your day shift?

We would appreciate the opportunity to talk with users as we make our decisions to purchase Blood Bank automation, so any help you could give us would be great.

You can contact Audrey Faust, Central Laboratory Supervisor, 608-258-6903 or Barb Utphall, Blood Bank Technical Specialist, 608-258-6927.

Thank you!

Tammy Heath, MT (ASCP)

St. Mary's Hospital

Madison, Wi 53715

[rebel1]

We currently have the Immucor Echo in our blood bank. We have had it up and running for about 6months. At this time, our LIS system is not interfaced with Echo. WE hope this happens in the next revision of our LIS. I do not believe that the Echo is bidirectional The Echo is a batch instrument, much like its predacessor the ABS2000. Immucor sells this instrument as being " continuous access" but this does not mean it can "multi-task". Yes we have had the issues with only four samples at a time. They (service) say that some people have issues and some do not. We have had very little down time with our instrument. We usually get next day service. As for stats TAT, it depends upon where the instrument is in the process when you put it on because it will finish the test it is doing before it begins the next batch. The Echo will complete a batch of 4 in approximately 22-25 minutes. We really like the instrument even with it's software issues. It only takes about 3-5 minutes to put a batch on and you can go away and do something else. It is a great asset to the evening shift. QC as we have it configured takes about 40-45 minutes.

Feel free to contact me at martinnat1@aol.com if you have any additional questions.

[krichards]

The Echo does have a bidirectional interface. Since I don't have HCLL, I could not tell you about their end of things.

We have 2 Echos at our hospital, and this has allowed us to run our STATs without little or no delays.

I don't feel the Echo is a true walk-away, but I just moved back to BB from chemistry...the difference in technology is huge. However, it takes just a minute or two to start a run. You just have to come back when you're ready to result, or add on more testing.

We only have 2 day shift techs at our facility. So, it definitely has not saved us a tech, but it has enabled us to keep up with our ever-increasing workload. (Although we still need a third tech!) That will depend our your demographics, however. How much time is also spend doing other component prep, issuing, etc.

[MediaMan369]

We have a TANGO. The interface is not completed as of yet, and not sure of the HCLL.

I have heard of a software issue with processing more than 4 samples.

We have had the TANGO since May 2008 and it works fantastic. We have had one major problem, saline leaked from a fitting and shorted out a module PCB. We had next day service and have been doing the TANGO since. The couple of times we called Tech Support, they have been great.

The TANGO is truely walk-away as well as readily available to add new samples at any time during processing without interrupting a run. We are currently processing approximately 70 - 80% of our daily samples (ABO, RH, Screens) and all of our donor confirmations (average 40/day) on the TANGO. It has really made a difference in our laboratory. For example, a couple of weeks ago, we had 3 Techs working. We processed 25 samples, 45 unit confirmations, signed out 28 units of RBCs, allocated and issued 14 platelets (10 of which had to be irradiated), thawed and issued 12 plasmas and answered the phone. All in 4 hours. All techs went to break and lunch.

We routinely evaluate our decision to purchase the TANGO versus the other analyzers that are available, and everytime, we know that we made the right decision.

[Candace Willilams]

I represent the manufacturer of the TANGO, Biotest Diagnostics and can provide you with some of the information you require. Currently the TANGO is interfaced to HCLL in a unidirectional mode, however, Mediware has completed the bi-directional interface and it has been submitted to the FDA for approval. Approval is expected within the next 30 days after which it will be installed at several sites.

The TANGO has a 144 sample capacity, but you can load 1 sample or 144. And you can continue to add more samples at anytime - continuous access. There isn't any limitation that testing on 4 samples have to be complete before adding more samples.

Being a third generation instrument, the TANGO is very reliable. Current 12 month average Mean Time Between Failure statistics are at 155 days between failures.

[Christie_75]

I represent Immucor, the manufacturer of the Echo, and can answer some of your questions regarding our instrument.

The Echo interface to HCLL is commercially available and is currently live at a customer site in the US. Echo is capable of a bidirectional interface, but HCLL only offers a unidirectional interface at this time.

The Echo is a true third generation instrument and features many hardware and software advances from previous instrument platforms that Immucor has marketed in North America – ABS2000, Rosys, DIAS, and Galileo.

The Echo is capable of running more than 4 samples at a time – this is a misconception. The instrument processes in groups of 4 samples, but in a continuous flow, so that a run of 20 type and screens completes in 80 minutes, with the results for the first 4 samples available 26 minutes after the run begins. A single type and screen can be completed in 20 minutes. With Echo’s linear racks, you never need to wait to load samples onto the instrument – as long as there is space available in the loading bay, you can load a sample at anytime. Tests can be immediately scheduled and you can walk away - Echo will begin processing these new tests at the first available opportunity. We plan to offer software upgrades in the future that will further enhance the scheduler.

Echo is designed for minimal maintenance – daily maintenance takes less than 15 minutes. Immucor manufactures a QC kit that is designed to be run daily on the instrument. These QC samples are provided in test tubes and are processed like patient samples, for true reagent and instrument QC. Echo also features remote diagnostics and customer changeable parts, allowing end users to experience more uptime in their laboratory.

While the Echo is a newer instrument, launched in June 2007, there are already a high number of placements in the North American market and instrument reliability to date has proven to be excellent. Our Mean Time Between Failure statistics are approximately 8-9 months between service calls.

[rebel1]

Does Immucor know what is causing the instrument to "freeze" while loading or programming additional test?

[Christie_75]

Does Immucor know what is causing the instrument to "freeze" while loading or programming additional test?

Yes - good news, Immucor just announced a software upgrade for Echo which will alleviate the software freezes that some customers were reporting.

[Peggy]

We are looking to decrease cost for our systems laboratories. We had some ideas for change, We are looking to see what others are doing. We use a combination of gel technology (not automated) and tube.

1. We currently antigen test in tube. Moving to gel would cut down on the now very expensive anti-sera used. I realize validation is required. What is your lab doing for antigen testing.

2. We were cited by our state on not performing reverse typing on our same specimen ABORH rechecks. As a result, our use of affirmegen has increased significantly. I do not believe our state has mandated this nor cited others. We are looking to approach the state for a revesal. Do you perform reverse typing on same sample rechecks?

3. DAT on cord bloods, we perform on all. Do any out there perform only when moms screen is positive or the possibility of ABO discrepancy exisits? I realize a pos DAT to a low incident antibody may get missed.

Your feedback appreciated!

[HS@maximgrp.com]

Hello - I was hoping someone could provide me with some quick info and possibly some color on the Echo vs. ProVue debate. Specifically

1. For either system, do you have to use reagents specific to the system. Can you use a traditional reagent used for manual testing in these systems?

2. Which one has a smaller footprint/requires less space?

3. Keep reading mixed input regarding STAT testing and ability to interupt batches. Does any system have a clear advantage in this respect?

Any color on the matter would be greatly appreciated.

[AMcCord]

Yes, you can use the same reagents for ABO/Rh typing on Echo and by tube.

Echo is a bit smaller and weights much less. Provue requires 20" space behind it for access for service. Echo requires 10-12". Provue also has a hatch that opens upward, so you would need to make sure an overhead cabinet wouldn't be in the way.

Edited November 22, 2008 by AMcCord

[John C. Staley]

.....But those reagents have to come from Immucor and be specific for the analyzer. They are bar coded so the analyzer knows what you've put on the instrument. That's true for all of the analyzers. The reagents can be used for tube / manual testing but they are sprecific for that analyzer. I assume the ABO/Rh regents for the Echo and Galileo are interchangable but I'm not sure about the solid phase strips. I know the ABS2000 was not.

Just thought I would add that little bit of clarification.

[AMcCord]

Good point John! Immucor Anti-A Series1, Anti-B Series 3, Anti-D Series 4 and Anti-D Series 5 plus Referencells run on Echo and will work for tube.

[marilynm]

I have a quick question. Do all the instruments perform antibody panels in addition to antibody screens?

Marilyn M

[bgruber]

Yes, I believe so.

The Tango is FDA cleared and capable of running Types, Screens (most importantly, pooled, 2-Cell, and/or 3-Cell,your choice!), Rh and Kell Phenotyping, Xmatch, Weak D, DAT, and Anitbody ID.

However, the Tango is the only instrument that has 7-day on board storage of reagents and 2 separate STAT capabilities.

[John C. Staley]

Marilyn,

The Echo does run panels. I'm not sure about the others.

Just to clear up any possible misconception someone may have, the instrument will not give you the name of the antibody (it's not that smart...yet). It provides the +s and =s, you have to figure out what they mean.

:abduction