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Who's Who in Point-of-Care Testing...

Diana DeHoyos

How long have you been involved in the POCT field and in what capacities?

I was initiated as a POCC in February of 1999 and am involved with discrete disciplines of manual waived testing & ppm’s, including the coordination of training and monitoring qc compliance and writing policies. In addition I also design and maintain our POCT website, co-coordinate our local POCC group (including co-ed of our newsletter) and design and develop learning material content for our Test Site Manager and Residents.


Please tell us which kinds of POCT you have in your institution and the approximate volume of that testing (either per month or per year)?


Our POCT menu includes:

  • Manual Testing: Guaiac, UA, strep A screen, UPT, pH, clinitest.

  • Automated: glucose, hemoglobin, hematocrit, ACT,  PT, PTT’s, hemoglobin A1C

  • PPMP’s: koh, wetprep, fern, UA sediment, nasal smears

Given UTMB’s decentralized layout, testing sites are grouped according 3 categories as reflected below (number in parenthesis reflects the number of sites), each reflecting annual test volume per CLIA category. 


•  Hospital including Campus Based Clinics (101)

  • Waived: 800,000

  • Moderate: 75,000

  • PPMP:15,000

  • Community Based Clinics (9)

    • Waived: 15,000

    • PPMP:  1,500

  • Regional Maternal Child Health Clinics

  • Waived: 550,000

  • PPMP:  45,000

A breakdown of Annual waived POC test volume (in thousands) for Inhouse sites follows:

  • Glucose 190

  • Guaiac 400

  • PH 14

  • UA 80

  • UPT 5.8

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What are some of the biggest changes you have seen in POCT during the time you have been involved in this field?  Please answer this from a global perspective as well as from the changes experienced within your own institution.

Globally, I believe it's the growing acceptance of POC testing as a reliable measure for patient assessment and treatment outcome; the growing need and parallel effort spent to fully automate and standardize compatibility & connectivity processes in order to close the loop on billing and patient medical record issues; and the standardization of quality control monitoring.  


The biggest change is yet to come however when the FDA publishes the finalized revised criteria for waived testing; yet to see how it will impact supply and demand or users and manufacturer’s and ultimately patient outcome.


At our institution, the biggest changes have been going from a one-sided perspective to seeking team effort (mainly nursing’s perspective) in the resolution of outstanding and problem issues.


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Are you involved with a POCT Committee within your institution and if so, what types of issues are commonly discussed during those meetings?

Yes, and I am an active member of this committee. Our continuous process improvement (CPI) team represents various departments within hospital (including nursing, laboratory, Quality Management and Supplies dept as needed) and meets on a monthly basis one year prior to due inspections so that we can discuss any outstanding issues. Among the most prominent issues discussed include:

  • Competency and Training Processes (includes re-certification frequency) for Nursing staff (on waived testing) and Faculty & Resident

  • Competency & Training (on ppmp’s and some waived testing) – Accomplished through

    • definition of such processes and coordinating  process with Nursing’s General Orientation to tackle nursing New-Hires, 

    • development of the Test Site Manager (TSM) program, the TSM being  a nursing employee within a given unit (or clinic) who is empowered by  the laboratory –TSM attends lecture on regulations, compliance, etc given  by POCC’s—and at the same time serves as liason between nursing and  the laboratory plus a leader or mentor to clinic/unit employees. 

    • elimination of the Train-the-Trainer program at sites where process was  unsuccessful

  • Identification of POC testing performed in in-house units

  • Standardization of POC use (kit/ monitors brands) across institution where applicable:  accomplished by the development of a formulary (institution POCT menu) and a vendor control policy followed by establishment of a POC Implementation process having laboratory as the approving party.

  • Compliance with regulations by those units maintaining a manual quality control program.

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Can you discuss a POCT initiative that you personally have witnessed that has turned into a positive outcome for either the institution or POCT in general?  This could be a PI plan, an evaluation of a product, or any type of process that has changed the way in which your institution addresses POCT.  


Sure.  I can summarize those initiatives as follows:

  • Built website infrastructure—web page design, layout (navigation of), program mission, and other content reflected on web pages.

  • Evaluation of various online testing software programs followed by the implementation of one (webquiz writer, Eon Communications). This allowed the standardization of nursing competency and physician PPMP proficiency testing through the development of online testing modules—meant to serve for educational purposes as well.  Gathered clinical specimens for digital imaging for use in proficiency testing modules. (note: I held fulltime position in Bacteriology and parasitology for 5 years).

  • Programmed online QC module (using ASP scripting language) that collects monthly sample comparison data from various sites and automatically dumps data to access database. The program gives users feedback- Comparison Passed/ Failed – based on  the information submitted.  Prior to the development of the module sites used to fax data to POCC.

  • Increased compliance of sites where POC tests that involve maintenance of a manual quality control log are performed. Accomplished through routine site visits and staff education/counseling.

  • Co-designed and gathered learning material for Test Site Manager Training Module.

  • Co-established the QA/QI program for Point of care, a process that aids in the tracking of POCT compliance across institution using 4 performance monitors.  Sites get monthly feedback by accessing compliance report through POC website.  A cumulative Aggregate Score reflects compliance for a given month; the Test Site Manager reviews monthly reports and takes corrective action as needed and/or works with POCC.

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Who's Who Home

Diana DeHoyos
University of Texas
Medical Branch (UTMB), Galveston, Texas

Diana DeHoyos, is part of a two-person POCC team that manages over 2000 users in the POCT program at UTMB, a major academic health center providing health care for over 200 Texas counties by operating 98 health care sites. UTMB is comprised of 6 hospitals, 45 campus based clinics, and 47 community based clinics that are located from 1 to over 200 miles from the main hospital in Galveston. The POCT program at UTMB deals with glucose meters, coagulation instruments, and numerous manual POC tests that account for over 1 million tests per year.

Diana is also the recipient of the 2002 POCT of the Award presented by the AACC POCT Division.  For more on that, and about Diana, click here.

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Last updated: 09/16/2009  Questions or corrections: My Point of
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