Introduction
Our three academic institutions, Indiana University (IU), Northwest-
ern Memorial Hospital (NMH), and Wake Forest (WF), were among the
first in the United States to adopt the Beckman Coulter AU5800 series
chemistry analyzers. The previous analyzer systems at all three institu-
tions were the Beckman Coulter Synchron DxC800 series. At each insti-
tution these analyzers were, on average, 5–7 years old and having
problems typical for such systems at the end of their useful life. In addi-
tion, during the timeframe that the DxC800 analyzers were in use, the
test volume at each of the institutions had increased substantially. At
IU the annual volume of billable chemistry tests increased from 5.7 mil-
lion in 2005 to 7.9 million in 2012; at NMH the volume increased from
0.9 million (2005) to 1.2 million (2012); while at WF the volume in-
creased from 1.2 million (2007) to 1.5 million (2012). These increases
in test volume were predominantly due to expansion of the outreach
client base, addition of satellite draw sites and the acquisition or estab-
lishment of new affiliated hospitals. Moreover, given the increasing
pressures to contain healthcare cost, consolidation of testing also
added to the increased central core laboratory volume. At all three
institutions, specimens on which testing is not performed at outlying
locations are sent by courier to the main core laboratory where the
Beckman Coulter AU5822 analyzers and the robotic automation lines
are located. At IU four DxC800 analyzers were replaced by two
AU5822 and two AU680 analyzers. At NMH four DxC800 analyzers
were replaced by one AU5822 and two AU680 analyzers.