Point of Care pathology - Overview

REMOTE HEALTH ATLAS – Section 18: PATHOLOGY
POINT OF CARE PATHOLOGY - OVERVIEW
REMOTE HEALTH ATLAS
POINT OF CARE PATHOLOGY - OVERVIEW
1.
General Information
A Point-of-Care (POC) test is refers to a pathology test, performed on a small portable
medical device by a trained operator in a clinical setting (outside the laboratory) at the time
of the client consultation.
POC testing provides considerable advantages in the remote health care setting such as:
- a convenient and accessible service for the client, without the need for follow-up visit
to get their laboratory result,
- immediacy of the on-site result enables decisions on clinical management for both
acute and chronic are to be made by the treating practitioner in a timely manner, and
- improving health service delivery and clinical outcomes.
Primary Health Care Remote has a number of POC testing devices used in remote health
centres. Specific information for each device is detailed in relevant Atlas Items, namely:
i-STAT 1 Analysers: this portable device is used for a range of pathology tests including
electrolytes, urea, creatinine, blood gases, PT/INR and Troponin I.
The i-STAT® Analyser is designed to operate as a networked system allowing the electronic
downloading of client and Quality Control (QC) results from the device and the uploading of
software to the device. POC testing conducted on PHC Remote i-STAT® 1 Analysers is
managed through a partnership agreement between the Northern Territory Department of
Health (DoH) and the Flinders University International Centre for Point-of-Care Testing
(iPOCT).
®
Note: the i-STAT Analyser is not standard equipment in remote health centres. There are
approximately 30 analysers in the DoH Primary Health Care Remote network.
Diabetes Care Analysers (DCA): this device is used for measuring the Haemoglobin A1c
(HbA1c) in whole blood and albumin:creatinine ratios (ACR) in urine.
POC testing conducted on PHC Remote DCA Vantage Analysers is managed by the
Flinders University International Centre for Point-of-Care Testing (iPOCT) Quality Assurance
for Aboriginal and Torres Strait Islander Medical Services (QAAMS) Program.
Note: the DCA Vantage Analyser is not standard equipment in remote health centres.
CoaguChek XS®: this device determines Prothrombin Time / International Normalised Ratio
(PT/INR) for clients on oral anticoagulant therapy using capillary blood from the fingertip or
untreated venous whole blood.
®
Note: CoaguChek XS devices are Standard Clinical Equipment in identified Top End PHC Remote
health centres and may be considered and approved for other health centres on an as needs basis.
HemoCue® Hb Analysers: this Analyser is able to measure haemoglobin levels utilising
capillary, venous or arterial whole blood.
®
Note: HemoCue Hb 201+ Analysers are Standard Clinical Equipment in PHC Remote health centres.
Developed by: Quality & Safety Team
Endorsed by: Quality & Safety Manager
Date Released: March 2015
Page 1
Reviewed:
Review Due: March 2018
POINT OF CARE PATHOLOGY - OVERVIEW
REMOTE HEALTH ATLAS – Section 18: PATHOLOGY
Glucometers: a device which measures Blood Glucose Levels (BGLs) utilising capillary,
venous or arterial whole blood. As BGL self-monitoring helps a person to understand and
manage their diabetes, the document outlines the process for requesting a client-held
Glucometer for BGL self-monitoring.
Note: Glucometers are standard equipment for all PHC Remote health centres.
2.
Definitions
Nil
3.
Responsibilities
See Responsibilities in relating to POC Pathology devices in Atlas Items as detailed in
Section 1 General Information.
4.
Procedure
See relevant Atlas items as detailed in Section 1 General Information for device specific
information.
Note: Instructions for performing a Troponin T Sensitive Test are provided in the Information Sheet:
Troponin T Sensitive Test Procedures (Intranet document).
4.1
Medicare Information - Overview
A Medicare rebate may be claimed for some POC testing. Details where relevant, are
provided in related Atlas POC documents as listed below in Section 6.
5.
Forms
See Forms in relevant Atlas Items.
6.
References and Supporting Documents
Related Atlas Items:
CoaguChek XS®
Diabetes Care Analysers (DCA)
Glucometers
HemoCue® Hb Analysers
i-STAT 1 Analysers
Medicare Provider Numbers
Medicare Benefit Claiming
Medicare Items Provided by RANs & ATSHIPs
Pathology - Documentation
Information Sheet: Medicare Compliance - Pathology
Troponin T Sensitive Test Procedures (Intranet)
Medicare Cheat Sheets:
Medicare Cheat Sheet - Medicare Items Provided by ATSIHPs & RANs
Medicare Cheat Sheet - Point-of-Care Analysers
Medicare Cheat Sheet - Simple Pathology
Developed by: Quality & Safety Team
Endorsed by: Quality & Safety Manager
Date Released: March 2015
Page 2
Reviewed:
Review Due: March 2018