Automated analyzers in the core lab aren't the only option for quality improvements--the chemistry side of urinalysis is also assessed at the POC, where it can contribute directly to improved workflow and efficiency as well as patient satisfaction.
"Whether in the emergency department [ED] or in the physician's office, POC urinalysis helps the physician initiate rapid treatment options such as drug therapy, further testing or patient discharge," Peluso-Lapsley noted. It offers a physician a whole range of rapid results serving as a window into a person's health or wellness, she added.
"In the ED environment, this efficiency can translate into more rapid bed turns. For the physician's office, the rapid response opens the possibility for the doctor to have immediate discussion with the patient regarding test results," Peluso-Lapsley said.
The challenges in near-patient urinalysis testing mirror those traditionally seen throughout POCT, but can be magnified, Peluso-Lapsley continued, because other POCT analyzers for glucose testing, coagulation and blood gases have had more sophisticated capabilities, especially in terms of connectivity. Recent improvements in urinalysis at the POC have reflected customer requests: operator identification, operator lock-out, quality control lock-out, interference identification and connectivity options.
"The POC marketplace is steadily advancing the adoption and integration of information technology solutions through incremental expansion of system connectivity and informatics offerings," Peluso-Lapsley explained. This is one of the most exciting areas of opportunity in near-patient testing, as effective data management opens the door for far-reaching improvements in healthcare.
Laboratories have choices regarding technology, footprint and volume. The automated urinalysis microscopy product from Sysmex, for example, utilizes a technology very similar to their hematology flow cytometry, while Iris Diagnostics, Chatsworth, CA, utilizes more of a visual technology. There are connected systems on which a laboratorian can place a rack on a track and the system automatically does chemical strips and microscopy. Small footprint urine chemistry analyzers for the POL and POC also are available, making improvements in workflow and patient satisfaction an attainable goal for labs of all types and sizes.
Kelly J. Graham is on staff at ADVANCE.