The Virginia Point of Care Coordinators group held their fall
educational meeting and vendor fair on November 20 at Sentara
Williamsburg Regional Medical Center. President Jacqueline (Jackie)
Canaday welcomed a very good turnout of approximately 50
participants with few spaces left in the room, and 11 vendors
represented.
“Point of Care Whole Blood
Creatinine and eGFR”
Jackie
introduced our first speaker, Dr. Jeffrey DuBois,
VP, Medical & Scientific Affairs from Nova Biomedical. Dr. DuBois
has been with Nova Biomedical since 1999. Prior to joining Nova, he
was on the faculty of the School of Medicine, Case Western Reserve
University and served as Executive Director of Laboratory Services
at University Hospitals Health System (UHHS), Cleveland, OH. At UHHS,
he established a system-wide strategy for lab consolidation,
standardization, and integration. He also implemented a POC Process
Improvement Initiative involving Nova’s Analyzers and Data
Management System for remote connectivity of analyzers located in
the ER, ICU's, and OR's to the laboratory. He represented UHHS and
Nova Biomedical on the NCCLS Automation Area Committee, initiated
served as Chairperson for the NCCLS Committee on Point-of-Care
Connectivity that published the POCT1A, and founded the Area
Committee for POCT for which he served as its Chair for two years.
Dr. DuBois is well published and a frequent speaker on
connectivity,
lab automation, lab consolidation, and point-of-care testing. He is
a fellow of the Academy of Clinical Biochemists, a member of the
American Association of Clinical Chemistry, American Society of
Clinical Pathologists, American Diabetes Association, American
Association of Diabetes Educators, The Endocrinology Society, and
the European Association for the Study of Diabetes.
Dr
Dubois’ lecture was titled “Whole Blood Creatinine Testing and eGFR,”
and concerned kidney disease and using Creatinine and eGFR to assess
kidney function. He elaborated on the extent of kidney disease that
has increased in the US related to lifestyle, and the lack of early
diagnosis to prevent progression of kidney disease. Dr. Dubois said
that “30% of people with kidney failure are only referred to a
specialist when the kidneys have already completely failed,” and
“7000 kidney patients in the UK are awaiting a kidney transplant,
but due to the shortage of organ donors 400 people a year die while
waiting.” He further discussed the two calculations used to
determine eGFR, and how someone with a 1.2 creatinine, while in the
normal reference range, could have an elevated eGFR indicating
kidney problems. Dr. Dubois ended his lecture speaking about POC
applications for Creatinine testing, and home use testing for
post-transplant patients in Europe.
After a break, a short business meeting was held. Jackie provided
coupons for participants to use for a fine shopping opportunity in
the nearby hospital gift shop. Members were reminded to vote for
2010 officers if they hadn’t already voted online; ballots would be
counted and results announced later during the meeting. The
committee members who helped plan this meeting were thanked for
their help planning today’s events: Jackie Canaday, Vickie Donnelly,
Cathy Owens, Bill Hankins, Lou Ann Wyer, and Lisa Durish, who had
helped even though she was not able to be present due to a work
commitment.
Business Meeting
Jackie
then introduced Bill Hankins, who gave an enlightening presentation
on his POCT home at Danville Regional Medical Center, where he
resides only 3 miles from the Virginia North Carolina line. Bill
began working there in 1972, and has seen many changes in the
hospital and it’s name, and recently a change in LIS’s from Sunquest
to Meditech. Bill gave us a snapshot view of his lab and it’s POCT
services, and also his personal life, which includes being married
for 40 years with 2 children and 2 grandchildren, and a prized 1976
silver Corvette! In addition to his hospital lab POCT duties, Bill
is also part of the Danville Lifesaving Crew.
Lou Ann Wyer announced that there were already 18 graduates of the
AACC CPOCT program from Virginia. She told everyone about the
pointofcare.net website that Steve Valorz had helped set up where
participants can network with peers, ask questions, etc. The site is
just open to the U.S. now, but may later be international as well.
Jackie thanked our sponsors for this meeting, Nova Biomedical,
Inverness Medical and Biosite, and Roche, who has continually
provided notepads and pens with the VA POCC logo for meeting
attendees.
Jackie gave a special thank you to Steve Valorz from
Medical Automation Systems - MAS, who is the “fastest webmaster” in
town and has access to a group that can help plan and coordinate
webinars. Jackie reminded all that you can log onto POC.net and find
other webinars to attend; there have been about a dozen since our
group held their first webinar in the spring this year.
Vendor Fair
After
lunch, attendees visited the well represented vendor fair, which
included displays by Nova Biomedical, MAS, Inverness Medical and
Biosite, Siemens Medical, Beckman Coulter, Quidel, Roche,
Aerscher
Diagnostics,
Hemocue, Telcor, and Abbott.
“Point
of Care Quality Control”
The afternoon part of the program started off with Jackie
introducing the speaker, Thomas I. Koshy,
Ph.D., Regional Scientific Affairs Director from Biosite, an
Inverness Medical Company. Dr. Koshy received his Bachelors Degree
in Biology from Kalamazoo College and then earned his Ph.D. in
Biochemistry, Molecular Biology and Cell Biology from Northwestern
University in 1991. After a pair of post-doctoral fellowships at
Northwestern’s Medical School and Abbott Laboratories Pharmaceutical
Division, Dr. Koshy joined the Abbott Laboratories Diagnostic
Division as an R&D scientist. His eleven year career at Abbott
Diagnostics spanned R&D, Manufacturing, Technical Support, Quality
and Scientific Affairs. Dr. Koshy’s experience covers many areas
including transplant, endocrine/thyroid, pregnancy/fertility,
hepatitis/retrovirus and cardiac diagnostics.
In
2006 Dr. Koshy joined Biosite (now an Inverness Medical company) as
a Scientific Affairs Director. The role of Scientific Affairs is to
serve as a scientific consultant for Biosite/Inverness and it’s
scientist and health provider customers. The Scientific Affairs
Director’s activities include research programs, technical support
for Biosite/Inverness customers and sales force and continuing
medical education lectures. Dr. Koshy presented a lively talk titled
“The Point of Care Quality Control Debate.” Intending to dispel
un-truths, he told us that the CLIA QC procedures thought to be law
have not yet become official regulations; the EQC options 1,2, and 3
aren’t law yet, though maybe the best suggestion so far. QC actions
are taken to prevent or detect failure, and the rise of EQC
procedures is because POC test manufacturers are good and getting
better. Dr. Koshy demonstrated evaluating “Risk vs. Hazard” by
discussing the chances that the ceiling mounted projector would fall
on Vickie Donnelly’s head. If using FMEA – Failure Mode Effects
Analysis, he suggested these be held in a tavern, as committee
members would be more likely to speak up. He ended by saying that
the future for QC, and not just in POCT, a risk management approach
to QC would find “no more one-size-fits-all (or
cram-the-square-peg-in-the-round-hole) formulas.” This would
represent a shift from mere QC compliance to true Quality Control.
Voting announcement/Wrap up
The
meeting finished up with newly voted officers being announced:
Secretary will be Janet Burckell from Mary Washington Hospital in
Fredericksburg, Treasurer Lisa Durish who is now with the VA Dept.
of Health, and President-Elect Cathy Owens from Carilion Labs in
Roanoke. Bill Hankins from Danville will move into the President’s
role, as we thank Jackie Canaday from Sentara Williamsburg and
Vickie Donnelly from Sentara Leigh in Norfolk for their hard work
and immense contributions as past President and Treasurer.
Next Meeting
Vivienne Coolbear volunteered Riverside Regional Medical Center in
Newport News for the next meeting location in Spring 2010. Some
suggestions for educational topics from the meeting and evaluations
included correlation of whole blood to plasma, connectivity and
barcode printer scanning issues, lactate and sepsis management,
glucose method variability, validation and correlation studies,
sensitivity to Plavix and Aspirin – Accumetrics, D-Dimer, how to
train non-lab staff on lab aspects of what they do, new POCT
molecular science or PCR tests or devices, finance aspects of POCT,
hospital profits and reimbursement.
Submitted by Cathy Owens, Secretary
