Blog . Cell Morphology. March 22, 2023

Challenges facing hematology laboratories today

Cell Morphology
Lianne Trantz
By Lianne Trantz

Hematology, like many fields of medicine, is moving towards a digital transformation where data is the key to diagnostic insights and building an effective plan of treatment. While this is an exciting evolution that brings with it incredible opportunities for improved clinical capabilities and ultimately, improved patient outcomes, there are challenges that need to be overcome before this transformation is complete.

Hematology laboratories are challenged with the organizational management of a shrinking workforce, increasing testing volumes and complexity of cases, limitations of remote-work capabilities, and inter-user variability of results.

Hematology analysis is critical to understanding a patient’s health and identifying blood-related diseases, including blood cancers and anemia. If supported by the right technology, experts can process samples more efficiently and provide faster conclusions, leading to improved patient care.

Let’s take a closer look at some of today’s greatest challenges for hematology laboratories:

Staffing shortages

There is a well-documented staff shortage that has grown more severe in recent years. This trend is seen across many industries – The U.S. Bureau of Labor Statistics cited a record 4.5 million workers quitting or changing jobs in November 2021.1 But while workforce shortages are affecting the entire healthcare ecosystem, there’s a particular strain being felt in hematology laboratories.

The British Society of Hematology found many vacancies in the hematology workforce, in a study published in 2020.2 This is due to a variety of factors, including higher rates of retirement combined with fewer people entering the field. This nets a negative influx of trained personnel available to cover shifts and share their expertise. The loss of experienced personnel without a sufficient number of graduates creates a greater workload for existing personnel, leading them to be overworked, burnt out, and experiencing low morale.

Rise in testing volume & increased patient complexity

A contributing factor to the strain placed on clinical labs is the increased demand for services. With the advancement of diagnostic and therapeutic techniques in hematology, more people are being diagnosed with cancer and other blood-related diseases. The world population is also expanding and aging.3 This means people are living longer and developing complex conditions with comorbidities. Consequently, labs are faced with a difficult question – how to maintain the standard of care and provide long-term treatment and disease management with limited qualified staff and more complex patients?

Limitations of remote-work capabilities

The traditional hematology analysis method, manual microscopy, has been utilized for generations. While today’s instruments have improved, one significant inherent limitation they have is the inability to remotely view or analyze slides. A sample is smeared onto a slide and viewed manually by an expert in the lab. This requires an expert to be physically present in the laboratory to conduct the analysis. It also means that there is no way to share slides easily between laboratories – whether for collaboration, consultation, or teaching purposes. Slides must be physically sent to another laboratory, or another expert must be invited to the original lab. This often hinders the diagnostic process.

Covid-19 showed the world the importance of remote work capabilities. Having laboratory experts review and analyze slides through the secure hospital network can decrease sample review time and help patients receive a diagnosis quicker, leading to faster initiation of treatment.

Inter-user variability of results

Traditional hematology laboratories rely on educated and experienced staff to make consistent clinical decisions using manual instruments, leading to the variability of test results. This is due to a number of factors, including differences in the way the tests are performed or the equipment used to perform them. Inconsistencies in every stage of the testing process can affect the results. Improper handling or storage of the sample before testing, analytical errors, type and quality of instruments used, and errors in interpretation or reporting of the results can all lead to the variability of results.

Increased demand for spending reductions

Laboratory directors are charged with reducing costs and maximizing product and instrument lifespan. In an ever more expensive world – the core inflation rate exceeded 9% in 2022 while national wage growth has experienced a 5.1%4 increase in the past year – labs are rightfully concerned about budgeting. Finding technological solutions that meet the needs of the lab, improve workflow, and help the lab reduce costs is a boon to hospitals and hematology laboratories.

Understanding the challenges that today’s laboratories face is an important step to overcoming those challenges and ultimately providing the best possible care to patients. Luckily, each of the above-listed struggles can be met with proper lab management, implementation of helpful technology, and laboratory automation.

1. S. Bureau of Labor Statistics. Number of quits at all-time high in November 2021. TED: The Economics Daily. January 6, 2022. Accessed November 8, 2022.
2. British Society for Haematology. British Society For Haematology Workforce Report 2019. Accessed November 8, 2022.
3. “Ageing and Health.” World Health Organization, World Health Organization,
4. Bureau of Labor Statistic. News Release, October 28, 2022, Accessed January 2, 2023.

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