November 20, 2009

Meeting Review

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 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 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

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