Design feature 1 Single pathology platform

It is clear from the above research that the designers of the LSPA system intended their system to function as a single automated platform, designed to incorporate analysers from as many pathology disciplines as possible. The design was developed to link disparate disciplines in order to facilitate ‘multi-disciplinary working’. As a result of this design decision, staff that had previously worked in isolation would be physically brought together and encouraged to work within the material confines of the single platform.

Accordingly the design features of the instrumentation facilitate multi-disciplinary working. As Figure 8 illustrates the tracking platform provided by the primary supplier is a single continuous production line, with individual analysers physically linked to the track. Following manual specimen delivery onto the specimen handlers the entire pathology process is in theory fully automated. Specimens are transported to individual pieces of equipment via

the automated tracking system and robotically loaded and unloaded from the individual analysers before subsequent automated storage. The materiality of the tracking system itself is designed to constrain the user, removing previously manual steps with an automated process. Human agency within this system is reduced to essentially loading and unloading specimen racks following analysis, together with subsequent validation of abnormal results.

The single-track option produced by the primary supplier within the context of this research is not the only automated pathology system on the market.

Instead of a single track, designed to bring together disparate pathology disciplines, other designers have developed a dual tracking system, which separates the disciplines of haematology and biochemistry into two individual platforms. As stated above by manager 1 only 15-20% of customers worldwide have actually purchased the single-track option incorporating both haematology and biochemistry. It can only be assumed that the remaining 80% of primary supplier customers have purchased a hybrid dual track system, which would include the primary supplier option as illustrated in Figure 8 minus the haematology equipment. As the primary supplier described within the context of this research does not produce a dedicated haematology track it can only be assumed that the remaining 80% of customers have purchased the haematology track from a competitor.

Figure 8. Primary supplier dual track option

One of the primary questions to be answered as part of this research was to investigate whether the intentions of designers of technology were subsequently realised in practice. With regard to the introduction of multi-disciplinary working the answer must be a resounding no, as 80% of customers have opted for a dual platform.

The decision to select a single or dual track system has obviously got to be made prior to implementation. As such this represents a bridging activity between the designer and the user or more accurately the designer and the manager of the user. In this respect this research has highlighted a limitation of previous work into the effects of technology on organisational design. Previous work has focused either on the development and design of technology or on the effects during or after use as two separate entities, the bridging activity of selection of technology has been given little if any attention. The reasoning Automated Biochemistry specimen delivery via tracking system

Centrifuge Specimen Handlers Centrifuge

Centrifuge

Automated Haematology specimen delivery via tracking system Centrifuge

behind the decision to select a single or dual track system will be explored in more detail within the next Chapter (6) following a series of semi-structured interviews with pathology managers involved in the procurement of LSPA.

With regard to the perceptions of the primary supplier, however resistance to adopt a single platform and hence introduce multi-disciplinary, appears to be culturally driven. Following the implementation of a fully automated tracking system in one large laboratory, manager 1 stated that the supplier had been asked to remove the system:

‘people that like instruments gravitated towards chemistry and people who didn’t like instruments gravitated to disciplines like haematology or micro (Microbiology) or blood bank’. ‘We have placed (LSPA) within Haematology and we have had the lab come back to us two years later and say take it off. Why? Not because it didn’t work, it’s because they still could not break down the walls between the divisions’ (S1)

‘the haematology pathologist was standing there while it was going in and she is looking at me with evil eyes and said “you see this line on the floor Mr A”. “I never ever want to see that track cross this line”.

You know what’s in there now seven years later? The (LSPA) is in there and the same lady came up here and is looking me in the eye and says “I can no longer afford to ignore the labour savings provided by automation, I give up!” (S1).

‘you know I am a medical technologist and I remember getting trained and I remember going through Haematology and going through Chemistry and all the different disciplines and the Haematology people saying look if you want to play that numbers game, if you want no art to your work, go down to Chemistry. If you really wanted to be a scientist and look down microscopes, you stay down here with us’ much in the way of common ground’ (S4).