The healthcare paradigm is moving rapidly toward point-of-care testing (POCT) in several areas. With this dramatic move, however, there are several issues to take under consideration. The benefits entail such things as increased timeliness of results and convenience for patients. Among the potential issues, however, are the possible costs of these tests, the reliability of the machines and the standards of quality and regulations hospitals must work to meet with the added equipment. Following are the thoughts of several experienced practitioners in the field of POCT, including Mark Crowther, MD, at McMaster University, Kim Gregory MT (ASCP), NCA, CLS, Associate Director, POCT at Massachusetts General Hospital and Lara Moody, MLT (ASCP), coordinator of POCT at Dartmouth-Hitchcock Medical Center in Lebanon, NH.
Q&A with Lara Moody:
ADVANCE: What steps do you take to ensure proper documentation and storage of results after POCT procedures?
Moody: If I had my way I’d have every test we do interfaced so that documentation and storage would be seamless, but this is still a ways away for many POC tests. We still have a lot of our results recorded on paper log sheets. These are forwarded to my office monthly and reviewed for completeness. We also have a report that is generated from our EMR so that I can make sure that the tests are being entered into the medical record. My office is full of three ring binders going back 2 years so that I can ensure the records aren’t discarded prematurely.
ADVANCE: What pre-analytical/evaluation steps does your facility have in place in order to ensure the quality of POCT devices?
SEE ALSO: The “Tricorder” of Patient Care, Part 2
Moody: Our validation protocol for new tests varies depending on the test system. For a waived qualitative test kit, we would run quality control and also patient sample correlations to check the accuracy and sensitivity of the test. For an analyzer we would check quality control, linearity, establish the analytical measurement range, precision and patient sample correlations. Depending on the quality control requirements and the complexity of the test, we would need to establish our on-going quality control program as well.