Improving Clinical Decision-Making and Efficiency in Healthcare Settings

Katie Mims, RN, BSN, Director of Clinical Affairs, Point of Care, Abbott Katie Mims Katie Mims is a registered nurse and director of clinical affairs for Abbott’s Point of Care business. In this role, she leads the global clinical study programs as well as publications related to i-STAT's point of care testing. Katie has particular expertise in reimbursement strategies and in the clinical, financial and operational value of point of care testing, specifically Abbott’s i-STAT System.

Innovative technologies allow clinicians to run common blood tests at the point-of-care. Data presented recently at the European Society for Emergency Medicine (EuSEM) Congress held in Italy, demonstrated that the i-STAT handheld analyzer was able to very rapidly provide clinicians with the information needed for making decisions in patient care. SelectScience’s Clinical Editor, Sonia Nicholas, spoke to Katie Mims, Director of Clinical Affairs, Point-of-Care, Abbott, to find out more.

Abbott i-STAT System

SN: Can you tell us briefly about the i-STAT?

KM: Abbott's i-STAT System is a handheld device that performs a broad range of blood tests that assist in diagnosis for many different medical conditions. The platform can be used at a patient’s side and allows clinicians to accurately analyze real-time, lab-quality results where and when they are needed within minutes rather than hours, which could help clinicians make quick decisions for effective and efficient care.

The i-STAT System is used in a variety of health care settings, including emergency departments, intensive care units, operating rooms, as well as catheterization labs, out-patient clinics, physician offices and ambulances, among others. There are more than 50,000 i-STAT analyzers used worldwide to process approximately 50 million test cartridges each year by trained health care providers (physicians and nurses). Currently, it measures 26 different analytes or substances in the body across 19 different testing cartridges.

SN: What are the benefits of the i-STAT analyzer?

KM: The i-STAT is lightweight, portable and easy-to-use and features single-use disposable test cartridges that can be used to perform a broad menu of diagnostic tests, including cardiac markers, blood gases, chemistries/electrolytes, coagulation, lactate and hematology. Testing is as easy as a nurse or doctor entering patient information into the handheld device, placing two or three drops of blood on the testing cartridge, inserting the cartridge into the device, and viewing the test results at a patient’s bedside in just a few minutes.

Abbott's i-STAT System 

Findings presented at EuSEM

SN: The findings of some key studies regarding the i-STAT were presented at the European Society for Emergency Medicine (EuSEM) Congress in Italy recently. Would you be able to summarize the findings of these studies for us?

KM: Three separate clinical studies conducted in France, Germany and the United Kingdom demonstrated key benefits of the i-STAT technology:

• "Point of Care Emergency Department Acute Rapid laboratory (PEARL): Win-Win for the Lab and for ED?" by Dr. Eric Revue (Chartres, France)

Revue E, et al[i] studied rapid point of care testing used in ambulances, which showed i-STAT technology proved useful in helping with diagnosis, decision-making and treatment in the mobile intensive care environment.

• "Point of Care Testing in the Emergency Department: Impact of POCT-Technology on Efficiency and Effectiveness of the Treatment Process in EDs" by Professor Wilfried von Eiff (Muenster, Germany)

von Eiff et al[ii] analysed the effect of using point of care testing to address overcrowding in the emergency department (ED). Their data showed the average length of stay for patients in the ED was reduced by nearly an hour when using i-STAT. Additionally, the availability of troponin (a specific protein in the blood that can indicate injury to the heart, such as a heart attack) testing improved to 15 minutes using i-STAT (compared to an average of 72 minutes using traditional lab testing).

• "Lab in the Emergency Department and Point of Care" by Dr. Paul Jarvis (UK)

Jarvis et al[iii],[iv] presented highlights that introduced point of care technology and its impact of redesigning the emergency department. Data shows that implementing a rapid assessment pathway with i-STAT shortened the amount of time patients spend in the emergency department by an average of 53 minutes (41.1% reduction). Also, using point of care testing in a triage-based model to test for renal function in the emergency department was significantly quicker than using a using a centralized hospital laboratory with a median reduction of 20 minutes per patient (15.5% reduction).

Benefits for busy departments

SN: What effect can point-of-care professionals expect to see if they implement i-STAT testing in their departments?

KM: In busy health care environments, the speed of the i-STAT technology can improve efficiencies for clinicians and their health care systems by simplifying the testing process. Additionally, as electronic medical records are being introduced more widely as standard practice, the wireless i-STAT can also automatically transfer a patient’s results, replacing manual entry of results and reducing the risk of human error. This means there may be savings from a time, cost and a staff resource perspective, allowing clinicians to focus directly on patient care.

SN: How is the i-STAT quality controlled and do users need training to use the platform?

KM: Abbott's i-STAT has built-in quality check systems by design, and we also have dedicated staff committed to continuously assessing our robust and thorough quality system. Training is required for users of the platform to ensure it is used properly and maintains local regulatory requirements.

SN: In which countries is i-STAT available? Does it have FDA clearance?

KM: Yes, i-STAT has received FDA clearance in the United States. The i-STAT System is currently used in more than 2,000 institutions in 84 different countries.

SN: Finally, do you have any new assays/product developments in the pipeline for 2016?

KM: Abbott is currently working to develop an expanded testing menu focused on cardiac, thyroid, neuroscience and blood conditions as well as a next-generation i-STAT System to improve efficiencies, drive down costs and improve patient care.

To learn more about Abbott Point of Care products, visit www.abbottpointofcare.com.

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[i] E.Revue A. Henniart, S. Legros, M. Guerrier, A. Saddar, S.Racine. Emergency Department and prehospital EMS (SMUR), Louis Pasteur Hospital , Chartres (France)Place of POCT iSTAT® in an MICU prehospital ambulance

[ii] W. Von Eiff et al, Klinikum Augbsurg, Germany. Efficiency and Effectiveness of POCT Procedures

[iii] P Jarvis et al. Does rapid assessment shorten the amount of time patients spend in the emergency department? British Journal of Hospital Medicine. 2014 Nov;75(11):648-5.

[iv] P Jarvis et al. Can the Introduction of Point-of-Care Testing for Renal Function in the Emergency Department Reduce Overcrowding? Point of Care: The Journal of Near-Patient Testing & Technology: March 2015 - Volume 14 - Issue 1 - p 42–44