University of Texas Medical Branch scales daily antibody testing capacity by 67x using Microsoft Azure

Since the start of COVID-19, the University of Texas Medical Branch (UTMB) has been a leader in diagnostic testing, delivering much-needed services to the region and state. “The more tests we could provide, the better we could stop the spread of the virus, so we in the laboratory field felt a lot on our shoulders. This was our opportunity to show everybody what the lab was capable of,” says Juan David Garcia, Director of Laboratory Services at UTMB. The scale of UTMB’s testing operations meant that any bottleneck would be a severe obstacle to care, so the laboratory team at UTMB decided to employ robotics to speed up testing processes while also improving human safety.

Searching for a cloud services provider, UTMB chose Microsoft for its broad range of offerings, high levels of security, individualized support from cloud solution architects, and compliance with UTMB’s robust patient data protection policies. Microsoft had proven its trustworthiness in past projects, so UTMB extended its confidence to Microsoft Azure, which offers services to create and manage automated cloud-based solutions. This support empowered Dr. Peter McCaffrey, Director of Pathology Informatics and Laboratory Information Systems at UTMB, to innovate using a new set of resources, spearheading the development of a cutting-edge system that increased testing speed and volume, reduced costs, improved human safety, and saved lives in the process. 

Responding quickly to COVID-19

Located in Galveston, Texas, UTMB is a renowned academic health science center that is part of the University of Texas System, one of the largest public university systems in the world. UTMB serves critical and impoverished populations with expertise and an unwavering commitment to advancing healthcare and improving patient outcomes. The Department of Pathology, led by Chairman Dr. Michael Laposata, MD, PhD, launched pioneering efforts during COVID-19 that included the introduction of neutralizing antibody testing into clinical practice. “Our number one mission is to provide excellent care to our patients regardless of the funding environment, logistical constraints, or the availability of employees and staff, all of which were challenges during the pandemic,” says McCaffrey.

UTMB was a key player in the nation’s response to COVID-19 because it is home to the Galveston National Laboratory (GNL), one of the only Biosafety Level 4 research laboratories in the country. GNL scientists led by Dr. Pei-Yong Shi developed a novel antibody test that provides comprehensive immunity data. However, their daily testing capacity was fixed, while the demand for testing was growing rapidly. The laboratory team knew that it had to reimagine laboratory operations to bring this test to more patients and ensure the health and safety of the community.

The UTMB laboratory’s original testing protocol involved frequent manual handling of patient samples and reagents—including live COVID-19 virus, which is required to perform antibody testing. This was because the various laboratory components did not inherently communicate with one another. Previous attempts to establish direct integration had involved corralling vendors and building new hardware, but UTMB recognized the need for a simpler and more efficient approach and turned instead to Azure. 

Designing an automated system in less than six months on Azure

McCaffrey and the UTMB team collaborated with Microsoft partner ABB and developed an innovative solution with Azure that seamlessly connected separate components within the laboratory and allowed the team to define the language of communication between machines. Application containers hosted by Azure Kubernetes Service became the pivotal endpoints where machines could interact, and UTMB had full control in mediating these communications. Perhaps most importantly, it could trial and refine the system as needed. “I got detailed, direct, interactive responses and debugging expertise,” says McCaffrey. He attributes the team’s success to the freedom to design, build, and experiment with creative systems—an approach that supports exploring new ideas, identifying challenges, and refining solutions.

Built on Azure, this powerful integration solution not only simplified previously complex tasks but also elegantly orchestrated them. The UTMB laboratory team quickly moved from manual configurations to a fully functioning automated workflow. The new process protected lab technicians from direct interactions with the virus, making the system safer for staff and qualifying more candidates to work in the laboratory. UTMB expects that these successful prototypes can be adapted to solve similar problems in the future.

UTMB began active software development in June 2022, and in less than six months its vision had become fully operational with no major increases in budget or staff. “It’s remarkable what we accomplished in that short period of time,” says Garcia. With robust scalability features, even a small team can achieve significant results efficiently. 

Increasing testing from 15 to 1,000 tests per day with 3x faster results

With its new solution, the UTMB laboratory team performed antibody testing three times faster and increased testing capacity to 67 times the previous rate, jumping from 15 to 1,000 tests per day. By offering a true immune-response assessment with a quicker turnaround of 24 hours, UTMB helps patients stay confident about their immunity status and empowers them to make informed decisions that protect themselves and others. This is particularly crucial for immunosuppressed people, such as organ transplant recipients, who must constantly monitor their immunity. With the managed services and administrative capabilities of its new system, UTMB automatically handles the scaling of resources without the need for manual resolutions. 

Applying laboratory advancements to future research

UTMB’s automated system using Azure paves the way for lifesaving innovations that reduce health risks, cost relatively little to implement, and dramatically speed up service delivery. For example, UTMB can now approach vaccine development as a modular service, applying its testing process to COVID-19 and other viruses and pathogens.

As its ability to conduct large-scale and standardized testing opens new avenues for research, UTMB is accelerating medical development and contributing to global health initiatives. “As an institution, UTMB is a lot more open and confident in its ability to tackle the challenges of automation and embrace this new future,” says McCaffrey.