POCT made easier with informatics

Jan. 23, 2019

As the healthcare industry moves closer to the patient’s side, point-of-care testing (POCT) is becoming more relevant. With faster and easier access to results, healthcare providers can reduce lengths of stay and increase patient satisfaction by avoiding extended wait times for central lab results.1

With this positive trend come new challenges: How do point-of-care (POC) coordinators keep hundreds of devices up and running while managing training and certification and enabling secure access for thousands of operators? How do healthcare systems enforce quality control so that compliance and accreditation requirements are satisfied?

A POC coordinator’s daily challenges

POC coordinators face many challenges associated with their responsibilities. These include making sure all POCT devices are up and running, keeping downtime rates low, and ensuring instruments are used correctly by staff members.2 POCT devices often are dispersed in many locations across the hospital network and constantly change hands among staff members, increasing the likelihood that the instruments could be used by staff who are not properly trained on the devices. Consequently, POCT coordinators can easily lose oversight and control of POCT operations, which can cost time and money and affect the quality of results and even patient care.

Connectivity is a step often unintentionally missed during POCT implementation. With many market offerings, it is not uncommon for POC instruments to be purchased from a variety of vendors by different departments to meet the healthcare facility’s specific testing demands or budget. Each POC device has its own specific user interface. This means coordinators must maintain—and be trained to use—several different software solutions. They must understand each instrument’s functionality and limitations in addition to managing its quality control (QC), usage, and inventory. POC coordinators also must perform software updates for each analyzer to ensure security vulnerabilities are addressed. With all these tasks to manage, it is understandable why QC, adequate staff training, and oversight are key concerns for coordinators.

Maintaining POC instruments and overseeing the operators performing POC tests would be much easier if all the information and data from each instrument were accessible through one user interface in which coordinators could manage both the instruments and operators. POC informatics solutions enable POC coordinators to manage dozens of sites, hundreds of devices, and thousands of operators. Informatics is the process of taking data and turning it into useful information. With increasingly sophisticated capabilities and simpler interfaces, integrated and open POCT environments help to create a streamlined workflow for more-efficient program management.

Connecting all devices, regardless of the manufacturer

To arm POC coordinators with the information necessary for their management and reporting needs, manufacturers are offering tools that give them control over the factors most applicable to their level of oversight. With many different POCT devices commonly implemented in a single healthcare facility, an open middleware solution can help to improve workflow. One such solution can connect more than 180 models of POCT devices from 40 manufacturers to a central laboratory or hospital information system. This open connectivity gives POCT coordinators improved oversight of operations and instruments for their entire POCT program without forcing unnecessary conversion to a specific vendor’s instruments, which may not be the right fit for a specific patient population.3

An open system receives data such as patient and QC results from POCT devices, technically validates the data, and forwards the test results directly into the electronic patient record. During this process, the system documents all POCT device data, offers remote monitoring of POCT devices, and provides quality and user management to ensure compliance with all quality assurance and regulatory guidelines.

Integrating one of the world’s largest POCT networks with POC informatics

While POC informatics programs have been slower to take hold in the U.S., other countries have successfully implemented such programs, from which U.S. facilities can learn best practices. For example, Queensland Health operates and administers the public-health system for the state of Queensland in Australia. The health system faced the challenge of connecting and managing 300 POCT blood gas analyzers operated by over 8,500 users at more than 250 Queensland Health sites spread across Australia’s vast east coast and inland region. The POCT analyzers run approximately 4,500 tests per day, producing large volumes of patient and QC test-result data that must be validated and transmitted to the lab information system at Queensland Health’s headquarters in Brisbane.

A major challenge was the relative lack of resources and support in areas further inland from Queensland’s east coast. In a region where the nearest pathology lab is 310 miles away and roads can be impassable for months, the ability to reliably produce quality-assured test results locally is critical in improving patient outcomes. Patients living on the coast have access to big hospitals, modern equipment, and support for pathology and radiology. The further you travel inland, the thinner the support becomes.

Achieving acceptable test-result quality was difficult in the more remote areas. This was largely due to the mobile, transient nature of the operator workforce, many of whom were hired through staffing agencies and moved frequently from job to job. POC coordinator, Cameron Martin, shared that it was difficult to keep staff trained and to track their training, and testing quality suffered as a result.

After years of seeing error rates rise, Queensland Health was able to install an online training program. After much consideration, Queensland Health chose the open-connectivity POCcelerator Data Management System to consolidate its middleware. By adding the POCcelerator system, Martin can now train operators remotely, manage operator access, and precisely track their training so he knows which operators are current and which are not.

Installing the POCcelerator system has improved both the operations of the Queensland Health system and access to care across the country. By creating a well-connected POCT environment, instruments in the remote areas are used more frequently, and the results are recorded more accurately. Martin reported, “By making the system perform better, we can help deliver…a more reliable service in those areas.”

At the POC, achieving high-quality results relies on operators making fewer errors. With better tracking capabilities for operator training, the POCcelerator platform has created better-trained operators who produce higher-quality results.

Conclusion

As the digitalization of the healthcare industry progresses, connectivity of testing devices is increasingly important and should not be overlooked. Fast and easy data access from everywhere within a healthcare network can lead to faster decision making, better patient care, and even reduced length of stay.

For POC coordinators, managing dozens of sites, hundreds of operators, and thousands of devices is a job unto itself. They can meet this challenge now and in the future with an integrated and open POCT environment that improves outcomes and workflow while enhancing care delivery across clinical pathways.

The outcomes achieved by the Siemens Healthineers customers described herein were achieved in each customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that others will achieve the same results.

REFERENCES

  1. St John A. The evidence to support point-of-care testing. The Clinical Biochemist Reviews. 2010;31(3):111-19.
  2. Gramz J, Koerte P, Stein D. Managing the challenges in point-of-care testing: an ecosystem approach. Point of Care. 2013 Jun;12(2):76-9.
  3. POC open connectivity device driver list. Siemens Healthcare Diagnostics Inc.

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