We spoke with János Sáfár and Gergő Kürtös from VetMedLab, one of the largest providers of clinical laboratory diagnostics in Hungary for the last 20 years, about their experience installing Sysmex’s XN-V and DI-60V. In this second part of our interview, they explain how the new system has improved efficiency in the labs smear analysis, improving both the time it takes to process samples as well as accuracy.

SYSMEX
How many samples do you analyse per day, and what percentage of them require a smear?

VETMEDLAB
We process around 70 to 80 samples per day. Approximately 12% of our haematology samples require smears. We are planning to increase this percentage using the Sysmex system and the DI-60V, as these make performing smears significantly easier.

SYSMEX
How has the XN-1500V DI-60V changed the workflow in your laboratory?

VETMEDLAB
One major improvement with the Sysmex system is the introduction of barcodes, which has streamlined the process and made it much easier to work efficiently. Perhaps the most important change is the reduction in human error, as the system is highly reliable and integrates seamlessly with our LIS. We simply load the sample into the Sysmex device, and it handles the process.

Previously, preparing blood smears manually was a time-consuming task, even with our well-trained assistants. With the Sysmex system, they can now load the sample into the machine, which automates the process entirely. This not only simplifies the task but also improves the quality of the smears. We can now prepare and evaluate smears immediately after completing the administrative steps, eliminating hours of waiting for results.

The quality of the smears has also improved. Since the smears are made from fresher samples, the results are more accurate. The system saves time by eliminating the need to train staff to create high-quality smears manually.

The SP (slide preparation unit) does an excellent job of creating standardised smears. It adjusts automatically based on the haematocrit, ensuring consistent results. Factors such as the amount of blood, speed, and the angle of the spreading slide are perfectly calibrated, resulting in no variance in smear quality.

SYSMEX
Standardisation seems like a significant benefit. Can you tell us more about how this impacts your work?

VETMEDLAB
Previously, our staining processes involved manually changing the slides or using a basic stainer. The Sysmex system has completely revolutionised this aspect.

The staining is now so consistent that I can differentiate between feline and canine blood smears just by their colour. Feline blood smears tend to have a bluish tint, while canine smears appear more reddish. Feline red blood cells are smaller, and their neutrophils stain slightly bluer with the SP system.

There are virtually no stain precipitates, which is a huge advantage. The system also refreshes the stains each morning during the startup process, ensuring reliability.

This level of standardisation improves the accuracy of morphology analysis. Subtle changes, such as mild toxic changes in neutrophils, which cause a faint bluish hue in the cytoplasm, are now easier to detect. Overall, the system has significantly enhanced the quality and consistency of our diagnostics.

SYSMEX
You already mentioned that the system supports you in quality and standardisation, and now also provides better insights from the morphology. So, finally: diagnosing better. What does the team think of it?

VETMEDLAB
The team appreciates the system because it’s so easy to use. They only need to place the sample into the machine, and the process takes care of itself.

Previously, we used a system without barcodes or any automation during the preparation phase, meaning the samples had to be measured manually and processed individually. Now, with the Sysmex system, minimal preparation is required—just load the sample, and the rest is automated. This significantly reduces manual labour, taking only five to ten minutes of effort.

Our technicians particularly value the extra time they now have to focus on other tasks.

Maintenance is another area where we’ve noticed a huge improvement. Our old system frequently suffered from clogs, which were especially problematic with veterinary samples. Collecting blood from animals such as a distressed stray cat or a baby Chihuahua often results in microclots or underfilled tubes.

With the previous equipment, we spent a lot of time manually unclogging and washing the system, disrupting the workflow. Sysmex has eliminated these issues. The system handles veterinary samples far more effectively, ensuring a smoother and more efficient process overall.

SYSMEX
Regarding smears, we already mentioned that before, you were doing manual smears and manual staining. Am I correct in saying that you can now place the slides directly in the rack, and the system handles everything automatically after the counting?

VETMEDLAB

Yes, because it communicates with our Laboratory Information System (LIS), and we also input smear orders. Regarding the entire process – from counting, smearing, staining, and examining samples under the microscope – to now receiving results on the DI-60V screen.

SYSMEX

Can you estimate how much the process time has been reduced?

VETMEDLAB

Especially with leucocytopenic samples, manual counting was very time-consuming. It took at least five to seven minutes to count 100 leukocytes in such samples. However, with the DI-60V, you simply check the screen. Of course, some misclassifications need to be corrected manually, but I believe it is more accurate this way. It only takes about two minutes to correct the misclassifications, and then you have a percentage for the leukocyte differential.

Currently, for smear examinations, I no longer have to perform the count. I can spend my time on more important tasks, such as analysing differentials, checking morphology, and searching for blood parasites when there is suspicion.

This has made smear examinations much more enjoyable.

Regarding platelet counts, it is very convenient to perform them using the DI-60V. It's not much more difficult than doing them manually under a microscope by counting ten fields. However, doing it digitally is more enjoyable because the DI-60V provides nine fields, and you simply count them. It calculates the result, which can be included in the report. Although it's a small feature, it is an advantage. I enjoy doing things on the computer more than manually.

SYSMEX

Could you talk a bit about the possibility of electronic consultations facilitated by the DI-60V / utilizing the DI-60V?

VETMEDLAB

The DI-60V generates detailed images that can be converted into PDFs. There are times when the cytologist or haematologist is not present in the laboratory, but there are changes that practicing veterinarians need to be informed about. We can perform online checks, and they can send me the PDF.

I can review cells that are suspected to be neoplastic or have toxic changes in the neutrophils. My colleagues can send partial results to partners before I or other cytologists arrive in the lab. This also allows us to send PDFs to other laboratories for second opinions or educational purposes.

Digitalisation greatly assists in this aspect. Additionally, we can use these DI-60V generated images and PDFs for marketing purposes because the pictures are visually appealing.

While practitioners might not be as interested, pet owners appreciate the high-tech appearance, as it shows they are receiving advanced diagnostics.

I attach the DI-60V PDF files to every smear examination report sent to veterinarians, so they can show them to owners for communication or use them for second opinions. For quality control and traceability, DI-60V images can be reviewed months later even if the physical blood smears have been discarded, as digital storage is more manageable than physical storage.

This is another advantage of digital microscopy. We also use scattergrams in our results from the XN-V.

In summary, having satisfied customers is essential for lab growth with Sysmex. Not only does it improve haematology, standardisation, and lab efficiency, but it also serves as a marketing tool to promote these enhancements.

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