Impact of automation on mass spectrometry

• LC–MS/MS becomes an important analytical platform in clinical practices.
• Achieving total automation is a key to bring LC–MS/MS into routine clinical labs.
• Incremental improvements are essential for LC–MS/MS to achieve total automation.
• Automation includes sample acquisition, preparation, data review and reporting.
• Interfacing with LIS will gain immediate benefits in reducing labor intensity.

Mass spectrometry coupled to liquid chromatography (LC–MS and LC–MS/MS) is an analytical technique that has rapidly grown in popularity in clinical practice. In contrast to traditional technology, mass spectrometry is superior in many respects including resolution, specificity, multiplex capability and has the ability to measure analytes in various matrices. Despite these advantages, LC–MS/MS remains high cost, labor intensive and has limited throughput. This specialized technology requires highly trained personnel and therefore has largely been limited to large institutions, academic organizations and reference laboratories. Advances in automation will be paramount to break through this bottleneck and increase its appeal for routine use. This article reviews these challenges, shares perspectives on essential features for LC–MS/MS total automation and proposes a step-wise and incremental approach to achieve total automation through reducing human intervention, increasing throughput and eventually integrating the LC–MS/MS system into the automated clinical laboratory operations.