Meeting the needs of hematology analysis at point of care

Diagnostic testing is a critical part of standard medical practice and may occur in several rounds of gathering and interpretation of patient information, each round refining the diagnosis. Some diagnoses are more important than others to establish early.

Fever, for example, can have a trivial cause or be a manifestation of a rapidly progressive and lethal infection. Short time to diagnosis for early initiation of treatment can therefore be necessary to save a patient’s life.

A complete blood count is used to detect a range of disorders that affect the blood cells, including anemia, infection, and leukemia. Today, such testing is conducted using automated hematology systems.

The analysis is cheaper relative to many more specific tests, and therefore accessible. A complete blood count is thus requested early in disease investigations and results are used for decisions on further testing, in establishing a diagnosis, or to define a clinical treatment.

The growing demand for hematology testing can be attributed to the aging population and the increasing investments in healthcare in emerging markets.

Although the analyzers were initially developed for laboratory medicine, hematology testing at point of care is gaining an ever-increasing interest. Today, small benchtop analyzers are available from a range of manufacturers worldwide to cater the demand.

The diagnostic process spans several steps, from test selection and sample collection, preparation, and transport to sample analysis, result reporting, result interpretation, and clinical action, and errors can occur in all steps. Testing at point of care can reduce pre-analytic risks such as blood coagulation, as time between sampling and analysis is shortened.

However, the risk for errors related to sample collection and preparation increases when handled by non-laboratory-trained health workers.

Equipment manufacturers take several measures to support healthcare providers in minimizing the risk for erroneous results. The test device must use whole blood and not require sample manipulation such as manual dilution or centrifugation. Correct sample collection and handling is especially important in hematology to avoid rupture of the blood cells, resulting in inaccurate results.

As venous blood sampling requires an experienced and trained phlebotomist, near-patient testing devices often allow analysis of capillary whole blood collected from a fingerstick sample. Although capillary sampling also requires some training, the procedure is less complex and can also be easier on the patient.

In addition, function and performance of the analyzer should be robust and reliable, as service and support can be located at a far distance.

As the site for testing is not necessarily the site for interpretation of the results, connectivity that allows sharing data with off-site expertise supports the patient-centric approach that testing at point pf care constitutes.

An automated hematology analyzer may report results for more than 20 parameters, presented as values as well as in histograms, which are graphical representations of the numerical data of the different cell populations. An understanding of the histograms provides relevant information that supports a suggested diagnosis before further investigations are ordered.

Connectivity solutions can also support laboratory management in maintaining point-of-care testing compliance. Advances in point-of-care testing connectivity can provide oversight to support quality assurance and maximized testing efficiency.

Today, hematology analysis is considered moderately complex and not always allowed in a near-patient clinical setting.

However, with small devices that produce laboratory-quality analysis results that can easily be shared with medical expertise, it will no longer matter where the testing is done, only who interprets the results.