January 2024—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.
New guidance on lab analysis in diabetes
December 2023—The third and latest edition of recommendations for laboratory analysis in diagnosing and managing diabetes mellitus, released this summer, provide guidance on, among other things, ketone testing, glycolysis, and point-of-care testing. The last such recommendations were published in 2011.
Read More »In ED/urgent cares, the lab tests and the POC team
December 2023—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).
Point-of-care testing scorecard spotlights hits and misses
November 2023—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.
People, partners, and platforms at the point of care
September 2023—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.
Views on point of care versus core and more
February 2023—Point of care or core lab? An old question but a new conversation, this one on Jan. 12 between Stan Schofield, Brian Durkin, and CAP TODAY publisher Bob McGonnagle (asking the questions). Here’s what they said about that and health care economics, autoimmune testing, tube supplies—and, of course, the labor shortage because it affects nearly everything in health care.
Read More »How close to patients? Cost, quality, competition
July 2022—Point-of-care versus centralized testing, and automation, IT, and staffing. It all came together as industry executives and a laboratory director and a former medical director met with CAP TODAY publisher Bob McGonnagle on May 25, as CAP TODAY’s list of chemistry and immunoassay analyzers was going together. “I don’t worry much about the machines or reagents,” thanks to good-quality practices, said André Valcour, PhD, MBA, DABCC, of Labcorp, who noted the real focus is quality of information and information transfer. Susan Fuhrman, MD, formerly of OhioHealth, said, “We should always give our clinicians as much information as we can accurately produce and our reports should be as clear as we can make them.” And of the staffing crisis: “We have a perfect storm,” she said. Here is more of what they and the others had to say.
Read More »ED, lab views on point-of-care cardiac troponin
June 2021—Point-of-care cardiac troponin testing got a fresh look last December when an emergency medicine physician and a clinical chemist came together to talk about the use of both conventional POC troponin assays in a high-sensitivity era and high-sensitivity POC troponin testing when it becomes available.
Read More »SARS-CoV-2 testing: Buy, build, and borrow? Middleware solutions
April 2021—Whirlwind timelines, novel problems, and a never-ending workload: On the anniversary of the COVID-19 pandemic, pathology informatics leaders David S. McClintock, MD, and Christopher Williams, MD, reflected on the year’s onslaught of challenges.
Read More »For POC molecular, pauses, plans, and testing precautions
January 2021—The use of molecular assays at the point of care is exciting but a bit scary. That’s how Raquel Martinez, PhD, D(ABMM), described the state of the science for molecular infectious disease POC testing when she spoke in a virtual AMP session in November with Omai Garner, PhD, D(ABMM), of UCLA Health.
Read More »Three at AACC: rapid STI testing, toxicology, biosafety
November 2020—Point-of-care testing for sexually transmitted infections, toxicology investigation, and biosafety practices are three of the hundreds of topics that will come online next month during AACC’s virtual annual meeting.
Read More »POC panel talks diabetes care, data management, CGM
March 2020—Data management, diabetes care, the demand for continuous glucose monitoring, and device cleansing were up for discussion when CAP TODAY publisher Bob McGonnagle led a point-of-care glucose testing roundtable in January. Joining him were Todd Cullen of Arkray, Corinne Fantz, PhD, DABCC, of Roche, and Susan Fuhrman, MD, of OhioHealth Laboratory Services. Here is what they said.
Dodging point-of-care testing potholes in PT, IQCP
December 2019—For point-of-care testing, perform proficiency testing on only one method or instrument unless your testing procedure says all patient samples must be tested on multiple instruments. And if a single IQCP is written for more than one POC testing location, account for all variations.
Read More »Personnel paradox and more: POC pitfalls
November 2019—Point-of-care testing makes up only about 10 percent of all laboratory testing but the aggravation factor and number of people involved far exceeds that, said Deborah A. Perry, MD, medical director of pathology at Methodist Hospital in Omaha, Neb., speaking at CAP19 and calling POC testing “a whole different world.”
Read More »Rapid assay detects HIV, syphilis simultaneously
September 2019—The results of a clinical trial of a rapid assay for dual detection of HIV and syphilis were reported at the 2019 HIV Diagnostics Conference in March. If approved by the FDA, where it has been under consideration since 2018, the Chembio Diagnostic Systems assay would be the first point-of-care assay of its kind on the U.S. market.
Read More »Mass casualty plan puts point-of-care testing in the ED
May 2019—If a mass casualty event brings patients to Le Bonheur Children’s Hospital in Memphis, Tenn., clinical laboratory staff will head straight to the bedside. Le Bonheur Children’s Hospital is a level-one trauma center. Its new mass casualty response plan, two years in the making, has laboratory staff in the emergency department and triage areas, where they will perform point-of-care testing for frontline providers.
Read More »POC testing roundtable: risks, resources, relationships
March 2019—Infection control and the heavy demands on point-of-care coordinators were among the top concerns that came up in a recent CAP TODAY roundtable on point-of-care glucose testing. Publisher Bob McGonnagle spoke with four POC testing experts: Sharon Geaghan, MD, Cynthia Bowman, MD, Steven Cotten, PhD, and Corinne Fantz, PhD. Here is what they told us.
Read More »At-home testing for heart failure, transplant patients: Can it work?
January 2019—Medicare hospital readmission rates are down under the Centers for Medicare and Medicaid Services readmissions reduction program, though hospitals are still paying millions in penalties, in part because new conditions are included in the calculations.
Read More »POC glucose: views on volume, critical care, ACOs
April 2018—Test volume, limitations on devices used in critical care, consolidation, and population health is what CAP TODAY asked about when it spoke in March with the makers of three bedside glucose testing systems. Their systems and those of two other companies are profiled on pages 44-49. “The customers are more aware than ever of the limitations that are in the package inserts from the glucose manufacturers,” says Corrine Fantz, PhD.
Read More »Devices, decisions: POC glucose in the critically ill
January 2018—Using point-of-care glucose meters in critically ill patients can feel like tiptoeing through a regulatory minefield. Perhaps your preferred meter hasn’t been cleared by the FDA for use in this population. Or maybe you’re not sure which assay performance requirements should be regulating the performance of your meters. Or perhaps you’re still trying to define “critically ill.”
Read More »Making a smooth pivot to point-of-care IQCP
May 2016—Practically speaking, there’s a limit to the number of balls a human can juggle. And there’s probably a limit to how complex a quality control plan a point-of-care testing coordinator can handle. Last year, many POC coordinators felt that the Centers for Medicare and Medicaid Services would be pushing that limit pretty hard with its new Individualized Quality Control Plan.
Read More »IQCP without agony at the point of care
April 2016—For many point-of-care testing coordinators, the prospect of developing Individualized Quality Control Plans is far from enticing. But there has never been much chance that laboratories could opt out of the Centers for Medicare and Medicaid Services’ new quality control framework for much of their nonwaived testing.
Read More »Pressing questions in POC glucose testing
April 2015—Sometimes major changes to a health care organization’s point-of-care testing system come from powerful regulatory agencies in Washington, DC. Or they may arise when a child with diabetes objects to frequent venipuncture. In either kind of case, experts say, pathologists and laboratory professionals must form strong relationships with clinicians and build structural foundations to help them meet these and other demands.
Read More »Study, strategy lift up POC critical value practices
February 2015—Too many point-of-care glucose test results in the critical high and low ranges may be nonreproducible and therefore should be repeated. That was the finding of a study published last year that said POC glucose results in the critical ranges should be considered to have a relatively high probability of signaling a potential preanalytic error.
Read More »How POC testing is pushing the envelope
April 2014—It can be hard to remember a time when GPS was not available in cars, the Web didn’t exist, and only eight diagnostic tests were classified as waived and able to be performed at the point of care. But after CLIA’s enactment in 1988, those were some basic realities of location and speed.
Read More »Dropping the ball on critical value POC glucose results?
December 2013—Prompt reporting of critical laboratory results is considered an important patient safety goal. But for one of the most commonly performed tests, point-of-care glucose, there has been limited information about how critical results are handled. A new CAP Q-Probes study finds there is a great deal of variability. In addition to having widely differing critical result cutoff values, many laboratories are not repeating critical POC glucose test results for verification despite the relative high rate of erroneous results on first measurement.
Read More »An uneasy dance with POC glucose in the ICU
October 2013—Too much of a good thing can be wonderful,” Mae West famously said. And some feel our culture of excess reflects that value. Perhaps as a reaction there has been a surge of interest recently in the embrace of “enough” as a worthwhile goal. But when it comes to precise measurement of glucose values in the intensive care unit, the often-warring needs for speed and accuracy make the issue a critical matter of patient care. For point-of-care glucose testing in the ICU, how much precision is “enough”?
Read More »Missing transcripts, diplomas snag labs
April 2013—The paperless office may be just around the corner, and virtual reality may lie ahead too. But for the time being, when it comes to demonstrating that personnel have the required educational qualification to perform nonwaived point-of-care testing, the Centers for Medicare and Medicaid Services and the CAP have a message for laboratory directors: Primary documents are king. For accreditation under CLIA, it’s not enough to know personnel are qualified because of their certificate or license; you have to prove it with copies of their transcripts and diplomas.
Read More »New attention on POC device disease transmission
April 2013—When 19th-century Hungarian obstetrician Ignaz Semmelweis found that doctors could dramatically decrease puerperal infections by washing their hands with a chlorinated lime solution before delivering babies, his colleagues thought he was nuts. Why, everyone knew that infections were caused by noxious air!
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