We're finding the cartridge route no longer works. What equipment would you recommend we purchase?

We're finding the cartridge route no longer works with our reimbursements and are looking into upgrading to moderately complex and wanting to invest in lab equipment.  We would like to do 80053/84443/85025(wellness profile) and 80061, 84153, 84439 for starters since this is 80% of the lab we regularly perform. What equipment would you recommend we purchase?

That is quite a menu. Upgrading to non-waived testing involves many things. The Laboratory Director under non-waived testing must qualify. To meet qualifications, they must either have one years experience already directing a non-waived lab or take a 20 hour CME course. In Louisiana, the personnel performing non-waived testing must be licensed by the state and be qualified through testing or experience.The personnel must also obtain 12 hours annually of continuing education. That being said, their are several instrument systems to complete this menu, but no one single instrument will perform all these test. Let look at them separately.

Hematology -CBC The BeckmanCoulter AcT Diff or Diff2, the Abbott Cell Dyn 1800 or the Horiba ABX Micros 60 are all good choices for performing a CBC as are others. Your test volume will decide the best instrument for the money.

Chemistry - The Horiba ABX Pentra 400 or the BeckmanCoulter UniCel® DxC 600i Synchron® Access® Clinical System are good choices. Depending on volume the Biomerieux Mini VIDAS is a good immunoassay system for smaller volumes for test such as PSA, Thyroids, etc. BeckmanCoulter UniCel® DxC 600i Synchron® Access® Clinical System will perform both the general chemistries and the immunoassays as well.

Remember, you really need a good volume to make these tests worth while to perform in-house. You will also need qualified individuals to run these tests.