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Medical labs increase use of performance analytics;
Target strategic IT investments

MLO February 2024 | By Kara Nadeau

Digital transformation of processes and the resulting data and analytics generated are growing in importance across the healthcare industry, including medical laboratories. To understand how medical laboratory professionals are using technology and data in their operations, Medical Laboratory Observer issued its third annual State of the Industry (SOI) survey on laboratory data analytics.

Three key findings:

  1. Strategic IT priorities for labs
  2. Increased use of data analytics for all aspects of lab management
  3. Interoperability and data integration issues with laboratory information

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7 pointers for POC cardiac troponin measurement

CAP Today, January 2024 | By Amy Carpenter

Seven recommendations for the use of cardiac troponin measurement at the point of care were published last year and reported in a session at the Association for Diagnostics and Laboratory Medicine annual meeting, shortly after the recommendations appeared in print (Collinson P, et al. Clin Chem Lab Med. 2023;61[6]:989–998).

The guidelines and recommendations are those of the International Federation of Clinical Chemistry and Laboratory Medicine’s Committee on Clinical Applications of Cardiac Biomarkers (C-CB). Of the 11 authors, four are from the U.S.: Amy Saenger, PhD, and Fred Apple, PhD, of the Departments of Laboratory Medicine and Pathology at Hennepin Healthcare/HCMC in Minneapolis and the University of Minnesota, and Allan Jaffe, MD, and Brad Karon, MD, PhD, of the Department of Laboratory Medicine and Pathology at Mayo Clinic. (Dr. Jaffe is also in Mayo’s Department of Cardiology, and Dr. Karon is dean of the Mayo Clinic School of Health Sciences.)


In ED/urgent cares, the lab tests and the POC team

December 2023, By Charna Albert | CAP Today

A point-of-care testing team from TriCore was part of standing up three dual emergency department/urgent care centers in as many years, with a fourth set to open in March 2024.

“They are super busy, as was expected. There’s a great need for this type of site,” says Kathleen David, MT(ASCP), TriCore’s associate director for near patient testing services, which oversees all of TriCore’s point-of-care testing, including that of a large health care system in New Mexico.

The sites differ from other freestanding emergency departments in that they follow a hybrid health care model, developed by a consultant company, that combines emergency medicine and urgent care services under one roof. About 6,000 point-of-care tests are performed monthly at each site—more tests than are performed in some of the health care system’s smaller hospital laboratories.

David and her point-of-care team led POC test implementation for each of the ED/UC sites, which are located in Albuquerque and the surrounding metro area and see 120 to 160 patients a day.

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Point-of-care testing is the next step for respiratory infections

Dec. 2023, By Dhaval Waghela | MLO

After years of centralization in the clinical testing realm, the field is in the midst of a shift toward decentralization. This trend supports the goals of diagnostic stewardship and getting the right test to the right patient at the right time.

While point-of-care testing has been an option for some clinical situations for many years—rapid flu or rapid strep tests performed at primary care offices are good examples—the need for the full spectrum of testing options was starkly revealed during the COVID-19 pandemic. There was an obvious need for high-quality molecular tests that could be run in hospital laboratories and in reference laboratories. But with all of these clinical laboratories overwhelmed with testing demand, there was an equally clear need for point-of-care options, particularly at-home testing that made it possible for people to get a fairly accurate reading of whether they were contagious so they could take appropriate isolation measures to keep others safe.

For some healthcare situations, this is the model that will serve the entire clinical laboratory community best going forward: a hub-and-spoke approach that allows for all the benefits of centralized testing as well as the advantages made possible through decentralized testing.

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Actionable answers:
Targeted multiplex PCR respiratory testing at the point of care

By Alesia McKeown, PhD, MLO, NOVEMBER 2023

In the unpredictable post-COVID-19 pandemic era, patient expectations have shifted when it comes to diagnostic testing. Americans are more educated about diagnostic testing than ever before, and molecular technologies like polymerase chain reaction (PCR) are a household name. When patients have symptoms that could be diagnosed as SARS-CoV-2, influenza, or respiratory syncytial virus (RSV), they want answers, often expecting diagnosis and treatment in one visit.

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Point-of-care testing scorecard spotlights hits and misses


At the point of care, there are testing wins, some losses, and plenty of pitfalls. “Point-of-care coordinators all have the same problems,” says Meaghan Gladstone, applications consultant at Werfen. Until recently, Gladstone was point-of-care supervisor at the University of Pittsburgh Medical Center. In a session at this year’s Association for Diagnostics and Laboratory Medicine meeting, she told the story of UPMC’s point-of-care successes as well as what didn’t work, and how the clinical committee that now governs point-of-care requests is in place to prevent failures.

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Why Quality Matters


Quality is the mantra of medical laboratory professionals, but what is quality? What does it really mean? Why does it matter? Isn’t quality control (QC) good enough? Isn’t it the same thing as quality assurance (QA)? If we run quality control samples, why do we bother with external proficiency testing (EPT)? Isn’t plotting QC results on graphs good enough? What is the point of spending all this time and money on quality? Is it really worth it?

Quality is almost like a religion that everyone working in a medical laboratory is expected to believe in and practice. We run QC samples, controls, and the occasional EPT testing sample and may think that is good enough. Running these samples and controls is an excellent start but in itself is insufficient. Anomalous fridge/freezer temperature, QC, and EPT data need to be acted upon. There is no point in dutifully plotting out-of-range QC data or fridge and freezer temperatures without taking action. 

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Looking ahead to respiratory virus season


With respiratory virus season near, those with a close eye on it in August gave the lay of the land for test algorithms, technologies, and forecasts, even as SARS-CoV-2 and RSV cases were rising in parts of the country.

Roche Diagnostics is emphasizing to customers the importance of multiplex testing in differentiating between pathogens that cause overlapping respiratory symptoms. "But also we need to be closely monitoring what’s happening in the U.S.," says Alesia McKeown, PhD, scientific partner at Roche, "because indications might be that we’re going to have an early season."

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People, Partners, and Platforms at the Point of Care


Point-of-care testing—the requests and the committees that oversee them, the connectivity, what AI might bring. CAP TODAY publisher Bob McGonnagle on July 21 met online with a laboratory operations director and a medical director from large health systems and with company representatives for a look at where things stand today. Their conversation follows.

It’s important that we define what the term point of care is and what it isn’t. We know it’s testing that’s done close to the patient and for which the test result is provided when the patient is still onsite so an intervention, such as adjusting a dosage, can happen. We talk about the tradeoff—convenience versus cost. We know that point-of-care testing and central or core lab testing have to coexist. This is overlaid now with a serious shortage of skilled labor, and, increasingly, patients being directed to patient service centers for their draws.

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Disruptive Technologies at the Point of Care


A wrist-worn high-sensitivity cardiac troponin I monitor was one of the wearable devices and health monitors highlighted in a session on emerging technologies for point-of-care testing at the Association for Diagnostics and Laboratory Medicine meeting in July.

James Nichols, PhD, D(ABCC), of Vanderbilt University Medical Center, in his talk on disruptive technologies, cited a study published this year in which a transdermal infrared spectrophotometric sensor was shown to be clinically feasible for rapid, bloodless prediction of elevated hs-cTnI levels in patients with acute coronary syndromes (Sengupta S, et al. Eur Heart J Digit Health. 2023;4[3]:145–154).

For the study, 238 hospitalized patients with ACS at five sites in India were enrolled.

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Applying Laboratory Quality Principles to Real World POCT Systems

By Kathleen David, MT (ASCP) and Jeanne Mumford, MLS (ASCP)

In the Continuing Education article in the April 2023 issue of MLO, laboratory quality management systems were discussed and details provided on each component. When it comes to maintaining quality in point-of-care testing (POCT), we are often presented with very different sets of challenges than our laboratory counterparts. While POCT is subject to the same CLIA regulations, minimal guidance is offered on how to meet those needs in POCT systems. One challenge is that testing personnel who perform POCT are non-laboratorians, meaning that some of the guidance available may not be written in language that non-laboratorian staff can easily understand. Another is that ..

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What Can Go Wrong With Point-of-Care Testing?

Clinical Laboratory News / July/August 2023

Point-of-Care testing (POCT) provides rapid test results with the potential to improve treatment. Additional advantages of POCT include small sample volumes, a wide variety of tests available, little to no processing required to run the tests, and ease of use within the clinical patient flow. However, when incorrectly performed or inappropriately utilized, POCT can generate misleading results that require additional follow-up testing at increased cost and risk to the patient.

Just as in traditional laboratory testing, the majority of POCT errors occur in the pre-analytical phase. These are processes that occur before the specimen is analyzed. Unfortunately, the instrument, operator, or clinician interpreting the results cannot readily identify most pre-analytical errors. Some pre-analytical variables specific to POCT are patient misidentification, improper specimen collection, air bubbles, hemolysis, improper site selection, and interfering substances.


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Connectivity marks an evolution in point-of-care testing

Tech-driven diagnosis, accuracy and quality control are driving the uptake of point-of-care testing.

By Farhana Chowdhury

Patients are more comfortable with finger pricks versus a venous draw, which is strengthening the popularity of point-of-care testing across the globe, shared Prof. Rajiv Erasmus, Head of the Department of Chemical Pathology at the University of Stellenbosch in South Africa, at his session, “Connectivity strategies in managing Point of Care services” that took place on Day two of the Medlab Middle East Congress 2023.

Complimenting the phenomenon, multiplex testing is further set to be the next biggest trend in the field, as it provides an accurate diagnosis of multiple underlying infections in one sitting while retaining quality control. “We are now getting point of care instruments that are very precise, accurate, portable and use very small amounts of blood,” Prof. Erasmus added.

Prof. Erasmus was among the speakers sharing the latest insights and developments under the Technological Advances and Vital Clinical Impact track, supported by The International Federation of Clinical Chemistry and Laboratory Medicine.

Point-of-care testing is currently at the forefront of creating value in healthcare...

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The Role of Point-of-Care Ketone Testing in the Hospital

MLO | May2023 | Dennis Begos, MD, FACS

Blood glucose testing in hospitals using point-of-care testing (POCT) devices has been a mainstay of glycemic control for decades, and the benefits of this are well documented and recognized by patients, providers, and laboratory professionals. POCT measurement of ketones is a more recent development and is the next logical step in managing patients with diabetes in the hospital. Measuring ketones goes hand in hand with hyperglycemia, and POCT ketone testing confers the same advantages as it does for glucose: rapid, accurate results with the ability to make treatment decisions in real time.

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