A practical case for more flexible syndromic testing in the clinical diagnostic lab
The challenge many labs are trying to solve
In a customer interview, Jose Velasquez, Senior Microbiology Supervisor at NICL Laboratories, described a testing environment shaped by challenges such as:
- Growing demand
- Mixed customer needs
- Increasing reimbursement pressure
Across the long-term care facilities, physician offices, and hospitals the lab serves, one testing strategy does not fit them all. This provides the context behind NICL Laboratories’ decision to adopt LIAISON PLEX®.
Unlike traditional syndromic platforms that report a fixed set of targets, Flex™ Testing allows laboratories to start with the most clinically relevant targets and release additional results from the same run without needing more samples. This supports patient management for labs by broadening syndromic capability when warranted.
Why flexibility mattered more than a fixed panel approach
In the interview, Velasquez described a sharp rise in respiratory demand following the COVID-19 pandemic, alongside increasing pressure to deliver results faster. With two LIAISON PLEX systems, the lab increased throughput from “four tests in two hours” to “12 tests in two hours.” According to Velasquez, this “really reduce[d]” stress on the workforce while also accelerating result delivery.
Just as important, Velasquez said the lab gained “a great opportunity” to tailor testing to each facility, giving control back to his clients. When care settings can align testing with clinical context, it promotes effective diagnostic stewardship and enables more intentional patient care.
A more practical model for diagnostic stewardship
With Flex Testing, the lab can start with the most clinically relevant results and expand only when needed. This approach delivers actionable results first, while preserving access to broader information only when the clinical context supports additional testing rather than applying the broadest possible testing strategy to every patient by default.
NICL described using that flexibility to make syndromic testing more adaptable to evolving clinical and operational needs. Velasquez said this flexibility would enable the lab to:
- Use syndromic testing more intentionally
- Utilize “on the fly” panels for particular target combinations
- Help “tailor all our needs in a more efficient way”
That makes a meaningful difference for clinicians, as a more flexible approach gives the lab a way to support those different pathways on one system.
How this can improve clinical utility without repeating work
One of the strongest aspects of Velasquez’s account is the description of what happens when the first answer is not the last answer. He gave an example in which a patient tested positive for influenza and the physician subsequently ordered subtyping information. With the LIAISON PLEX® Respiratory Flex Assay, he explained that the lab did not have to rerun the sample.The additional raw data was already available from the same run and could be immediately analyzed and released in LIAISON PLEX with just a few clicks.
For the NICL team, this can reduce repeat testing, unnecessary work, and support stepwise clinical decision-making and patient management as the diagnostic question evolves.
Why a growing menu matters to NICL
While the core story is respiratory testing, Velasquez also pointed to the bloodstream infection (BSI) assays and the gastrointestinal (GI) assay as important extensions of the value LIAISON PLEX brings to NICL. Those assays are crucial because they demonstrate how the model can be applied to syndromic areas where clinical questions, resource constraints, and reporting needs may differ.
On bloodstream infection testing, NICL Laboratories was drawn to the practicality of a Gram stain directed approach. Velasquez explained that Gram staining supports more appropriate test utilization by helping the lab avoid unnecessary targets. For microbiology labs, that has significant clinical impact because it fits rapid molecular identification into established bacteriological workflows.
The same logic applies to GI testing. Velasquez said, “I think GI is going to be a great tool” because some physicians only want a narrow set of viral targets, while others may need bacterial targets or parasite coverage depending on the patient and setting. That makes the LIAISON PLEX® Gastrointestinal Flex Assay launch relevant not just as a menu expansion, but as another use case for the same Flex Testing architecture.
What the LIAISON® PrevaLENS™
Velasquez also highlighted the value of the LIAISON® PrevaLENS™ and its capacity to show positive trends across all specimens tested, including specimens that were not originally reported. He said that visibility could help the lab create testing algorithms that cover targets they had been missing. Additionally, it would also support more proactive customer guidance, panel design for local pathogen pattern shifts, and informed testing in nursing homes.
LIAISON® PrevaLENS™ supports analysis across LIAISON PLEX® instruments and testing sites, providing a clear, current picture of testing activity with practical operational value for Velazquez. In his words, “my numbers are live” and have “meaning” for ordering and resource allocation.
The practical takeaway
NICL Laboratories didn’t choose LIAISON PLEX simply because it wanted a syndromic platform, it chose LIAISON PLEX because the platform offered an adaptable testing model. The lab saw practical value in how LIAISON PLEX expanded respiratory testing capacity, improved workflow, supported customer needs across various care settings, and streamlined pathogen selection and reporting.
The core advantage was not just broader molecular capability, the advantage was control. Control over what gets reported, when broader information is released, and how testing aligns to patient presentation, customer setting, and reimbursement pressure. That is what made the platform feel sustainable for this customer.
Conclusion
Traditional fixed testing can be effective, but it does not always factor in the varying needs of each patient’s clinical picture.
The takeaway is simple: flexibility is not just a feature. It’s a practical way to support diagnostic stewardship, improve clinical utility, and align testing with real-word laboratory demands.
See how FLEX testing supports respiratory strategy across care settings.
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