Clinical diagnostic laboratories continue to face growing pressure from rising test volumes, increasingly complex testing menus, significant workforce shortages, and expectations for faster turnaround times at sustainable cost. Total laboratory automation (TLA) has become a central strategy for improving efficiency in high-volume laboratories, where integrated systems from Abbott, Roche, Siemens Healthineers, and Beckman Coulter have demonstrated substantial reductions in turnaround time, error rates, and labor requirements. Evidence across multiple health systems shows that TLA improves performance and stabilizes laboratory operations even during workload peaks. Despite these gains, large segments of pre-analytical and post-analytical workflows remain manual, especially tasks related to specimen transportation, bench-level manipulation, instrument tending, and troubleshooting. Recent progress in collaborative robotics (cobots), autonomous mobile robots (AMRs), and hospital service robots demonstrates that these technologies can complement TLA by addressing not only the logistical and dexterous tasks that fixed automation lines cannot reach but also enabling robots that can work safely right alongside humans in a shared space. Cobots have shown sub-millimeter precision in colony picking and other fine-motor tasks, though typically at lower throughputs than dedicated track modules, and AMRs have demonstrated reliable transport of pathology carts and medical supplies through large clinical environments. Meanwhile, humanoid-capable mobile manipulators, like Moxi from Diligent Robotics, deployed in hospitals are already completing hundreds of thousands of supply deliveries, indicating real-world significance. Here, we integrate technical, regulatory, operational, and business perspectives on TLA, collaborative robotics, and mobile platforms. We discuss real-world efficiency gains, regulatory expectations under the CLIA and United States FDA, and the emerging case for hybrid automation ecosystems that combine TLA islands, cobotic workcells, AMRs, and AI-enabled orchestration. We argue that the next decade of laboratory automation will move beyond monolithic tracks with robots toward flexible, modular robotic systems designed to operate safely together with humans and to augment the increasingly strained laboratory workforce. This not only allows clinical staff to dedicate more time to patient care but also ensures greater reliability and scalability for essential services throughout demanding hospital environments.
Mukherjee et al. (2026) studied this question.