Herlev Hospital near Copenhagen is a familiar landmark in the Danish landscape. Standing 120 meters high, it is one of the tallest buildings in Scandinavia, and under optimal weather conditions is visible from the Swedish side of the Øresund Strait. Inside, the calm and relaxed reception and route to our destination – the Clinical Microbiology Department – give little indication that this is one of Denmark’s largest, busiest and most prestigious hospitals. Serving a catchment area of 700,000 people and treating more than 80,000 patients per year, Herlev Hospital has more than 1,600 beds, 22 specialized departments and 4,000 staff.
Built in 1976, the hospital’s spatial design is resourceful and clever. Underground space houses diagnostic equipment, procedures and treatments are carried out in the wing, and patients’ wards are located in the tower. The interior, designed by artist Poul Gernes, incorporates a range of carefully considered colors to uplift patients and staff, and the hospital features functional architectural details such as rounded corners for ease of cleaning. Overall, Herlev Hospital is a welcoming and friendly environment, in which cutting-edge diagnostics, treatment, patient care and research are carried out efficiently and effectively.
In addition to its recognition as a national landmark, the hospital has reached impressive heights in care. Herlev Hospital is earmarked as a “super hospital” in a national plan to intensively develop five key hospitals – one for each of five regions in Denmark – over the next five years to incorporate a full range of medical specialization.
The Clinical Microbiology Department at Herlev Hospital carries out vital microbiological testing for a growing number of patients and will serve even more in the future. In 2013, within just three months, the laboratory was significantly expanded in line with the hospital’s emerging status. This created a 3.5-fold increase in demand in the overall number of tests. The Clinical Microbiology Department now comprises 120 staff, with around 25 of these dedicated to molecular testing.
Anne Kailow, Head of Molecular Diagnostics, Department for Clinical Microbiology at Herlev Hospital has led the molecular diagnostics laboratory for the last four years and managed the recent expansion of operations. During 2012, the Department carried out around 50,000 molecular tests. Later that year, regional reorganization including a merger with the nearby Hillerød Hospital and further internal development in Herlev’s transformation into a regional super hospital, required Ms. Kailow and her team to gear up for a major increase in capacity to 175,000 tests per year.
Reorganization of the department was an immensely tough challenge, because of the scale of the expansion and the limited time frame. In addition to coordinating relocation to a new space and acquiring additional equipment, the department had to recruit and train many new staff.
“Meeting the new demands required investment in new equipment that could significantly enhance our workflow through automation, and reduce the amount of hands-on work required,” Ms. Kailow said. “The new systems, of course, had to provide high accuracy and fast results. Practically, we had to implement the expansion within just three months, so we also needed systems that were available and could be integrated into use almost immediately, enabled optimal use of our very limited space and were fully compatible with our Laboratory Information System, or LIS.”
Among the systems that satisfied these requirements and were finally procured by the Herlev laboratory also based upon previous experiences were several QIAGEN instruments: three QIAsymphony RGQ, a modular platform for automation of laboratory workflows from sample to result, and a QIAxcel instrument for nucleic acid separation. In addition, the department will be integrating QIAlink, QIAGEN’s software to automate data handling between QIAsymphony and all LIS platforms, in 2014.
The right solution
“We are still in the process of adjusting to our new situation and fully integrating the changes, but we are convinced that we have chosen the right systems and partners to support us. In particular, the combination of QIAsymphony SP/AS and Rotor-Gene Q offers many advantages, such as the integration of automatic sample preparation with assay setup conversion, ease of use, minimal space requirements, possibilities that enable primary sample input and the option to integrate QIAlink software,” Ms. Kailow added. “There has already been a great deal of positive feedback on the QIAGEN systems and the results that we can achieve. My team particularly likes the continuous loading and SP to AS features.”
As well as enabling the department to meet the new workflow demands, it is also facilitating significant time-savings. And QIAGEN’s support has exceeded the supply of advanced new equipment: “Select members of our team have received more intensive product trainings to serve as super-users for the rest of our team, so we can continuously refine our workflows to ensure we employ the most efficient approach to cope with the day-to-day requirements,” Ms. Kailow remarked. “Hence, we now also plan to integrate the QIAlink software to facilitate data exchange and thus further improve our workflow. Over the next few years we will expand even further, and we are always looking forward to the next challenges, as QIAGEN does.”
Allies in automation
QIAGEN has provided diagnostic solutions to Herlev Hospital since 2005. Herlev’s Clinical Microbiology Department was one of QIAGEN’s very first customers when the company’s Danish office opened, and the initial connection quickly evolved into a strong partnership.
“Danish customers generally have a great deal of experience with research and development and want to be at the forefront of technology. Denmark has a strong, well-established and well-supported research culture. The Clinical Microbiology Department at Herlev Hospital recognized the suitability of our systems for their work as soon as QIAGEN technologies were available in this country and has become a long-term customer,” remarked Cate Poulsen, Senior Sales Representative at QIAGEN Denmark. “As well as providing our platforms and tests, we have supported the Herlev department over the years with support, service and even a trial system at one point.”
“Following the most recent expansion at Herlev, the department has created what we refer to as ‘The QIAGEN Wall’ – a dedicated area comprising a row of QIAGEN platforms to optimize their workspace and procedures. It can accommodate five to six people working simultaneously, enabling them to work more efficiently and with added comfort,” Ms. Poulsen said.
Meeting global trends
Herlev Hospital’s Clinical Microbiology Department is not alone in the recent challenges it has faced. Healthcare and other laboratories across the world face continuous demands for faster, more accurate results on an ever-increasing range of tests, greater volumes of samples, more flexible capacity in terms of workload, staffing and capabilities, reduced resources following healthcare spending cuts and major reorganizations. The drive for cost savings, enhanced workflow efficiency, standardization, and 24/7 capabilities continues, along with the need to future-proof operations to function effectively in rapidly changing healthcare and technological environments. Laboratory automation eases the impact of these challenges and assists in realignment with major changes.
QIAGEN strives to help its clients meet these challenges. We continually develop our offering in molecular diagnostics technology to provide customers, like Herlev, with a “one-stop shop” in precision, efficiency and affordability – including a range of instrumentation and an ever-increasing range of innovative tests.
Success of QIAsymphony
QIAsymphony is QIAGEN’s flagship platform. Sales of the systems have grown substantially year-over-year since the QIAsymphony introduction in 2008 and surpassed 1,000 cumulative placements in 2013. Around 50% of all QIAsymphony platforms are currently being used in the Europe, Middle East and Africa (EMEA) region, 30% in the Americas, and 20% in other markets. Following this success, QIAGEN has set new targets aiming to achieve 1,250 cumulative QIAsymphony placements by the end of 2014 and 1,500 by the end of 2015.
“Key to the success of the platform is that the system not only offers a high level of quality and accuracy, but is also straightforward to operate,” said Line Martinsen, Business Manager for QIAsymphony. “Important features include continuous loading ability and the fact that different reactions can be performed within a batch of samples by means of the so-called ‘random access method’ without having to recharge with reagents. What makes our system so special for customers, however, is its high level of operational efficiency: QIAsymphony works both with PCR-based test kits from QIAGEN, as well as laboratory-developed tests (LDTs), enabling customers to consolidate their assay menu into one workflow. This is a key differentiator, since in many laboratories as much as 50% of all tests are devised by the laboratories themselves.”
Expanding range of tests
QIAGEN constantly expands its assay portfolio, and this growing menu increases the efficiency and value of the QIAsymphony platform for customers. New tests launched in 2013 include the artus CT/NG QS-RGQ Kit for diagnosis of the sexually transmitted pathogens Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG), which was launched in Europe, and the RespiFinder RG Panel, the first highly multiplexed pathogen assay designed to run on the Rotor-Gene Q, allowing for the simultaneous detection and differentiation of 21 respiratory pathogens with a CE-IVD compliant workflow. Respiratory tract infections (RTI) are the most widespread type of acute infection in adults and children and are a significant cause of mortality in immunocompromised patients. The fast results provided by the test will improve therapy and may help to improve patient outcomes by preventing unnecessary treatment or hospital admission. In addition, QIAGEN is rolling out a growing portfolio for diagnosis of hospital-associated infectious diseases.“The process of developing new tests starts with customer interest,” Ms. Martinsen explained. “We delve deeply into the wider potential of specific tests and initiate the development of promising new candidates.” As a result, QIAGEN currently has more than 35 new tests in its development pipeline for the QIAsymphony platform, which will further increase the value of this platform for existing and potential customers and drive its utilization.
QIAGEN not only strives to expand the content of its assay portfolio, but also its geographic footprint, making both the platform and the corresponding tests available in more countries worldwide. A recent milestone in these efforts was the submission of the entire QIAsymphony RGQ MDx platform for regulatory clearance in the U.S., following earlier clearance of the Rotor-Gene Q MDx detection module along with a diagnostic test for influenza.
Exploring new horizons
Seamless, flexible and reliable workflows such as those provided on the QIAsymphony system are important to all customers in the diagnostics space. QIAGEN also is working to apply the successful QIAsymphony formula to other fields where new challenges exist. A particularly important field is next-generation sequencing (NGS), where current bottlenecks in the workflow are hampering the dissemination of this new technology in healthcare.
QIAGEN is creating an industry-leading portfolio of products and services to drive the adoption of NGS in clinical research and diagnostics and create a new workflow, which integrates all the different steps from raw biological samples to valuable molecular insights. Responding to customer needs for more reliable, efficient NGS workflows, the company is commercializing an increasingly broad range of universal solutions compatible with any major NGS platform on the market, including pre-analytic kits such as the REPLI-g Single Cell Kit for sequencing from single cells and minute amounts of DNA with highly accurate results, and an expanding portfolio of GeneRead™ DNAseq gene panels for use in cancer and other diseases.
Back at Herlev Hospital in Denmark, the impressive views from the window of the Clinical Microbiology Department on the fifth floor mirror the new horizons in molecular testing that QIAGEN systems have already brought the department, providing insights that benefit staff, specialists and patients.