In dieting—as in so much else—good intentions aren’t enough. To lose weight, calorie-counters can’t stock up on carrot sticks and hope for the best; they have to actually monitor their diet via a food diary or some other method. (Hence the saying: “If you bite it, write it.”) But if the monitoring method becomes too cumbersome, it’s likely to go by the wayside, and any new, healthier eating habits will probably follow.
Conversely, making the monitoring process as painless as possible is a major step toward success. And that’s a lesson that applies to many endeavors, including tight glycemic control.
“Because of the increased testing frequency mandated by most tight glycemic control protocols,” says LifeScan marketing manager Grant Choe, “anything we can do to increase ease and simplicity is going to be welcomed with open arms.”
Harlan Polishook, Nova Biomedical marketing communications manager, agrees: Under tight glycemic control protocols, he says, some nurses find themselves performing bedside glucose testing “as frequently as every half hour for some patients.” In turn, “more frequent bedside testing has driven the demand for faster, easier testing and smaller blood volumes.”
The makers of the bedside glucose testing systems featured in this month’s instrumentation survey have responded to that demand with new and forthcoming instruments and features, from multiple measuring wells to wireless capabilities.
Though one LifeScan offering, the OneTouch Flexx meter, has been on the market for some time, it’s receiving new attention. Choe says that’s because the FDA has recommended glucose-specific testing methods such as glucose oxidase, which the OneTouch Flexx uses, “to ensure accurate results in patients receiving treatments containing maltose or its metabolites.” Institutions that don’t use such methods, he adds, “may be forced to implement extra corrective measures as recommended by the FDA and ISMP [Institute for Safe Medication Practices], which add complexity to the blood glucose testing process.”
In addition, as Choe points out, it’s not as if hospitals are simply testing more often; they’re also having to manage the greater amount of information that results. “The increased testing frequency also generates more patient data,” he says, “and with it comes an increased demand for outcomes reporting.”
To that end, LifeScan has introduced two system enhancements: a wireless connectivity solution and an improved means of remotely accessing critical data. The first, OneTouch DataLink Wireless, “brings fast, accurate, robust data exchange to the bedside,” Choe says, while the second, OneTouch DataLink Web, “uses thin client technology to give users secure access to data anytime and anywhere.”
Mary Catherine Coyle, Roche marketing manager for hospital glucose testing systems, says her company’s customers frequently cite “the need to fully integrate point-of-care information with patient care systems and complete electronic medical records.” She points as well to recent surveys by the American Hospital Association and the Healthcare Information and Management Systems Society that found customers focused on the importance of real-time information in improving patient care.
One tool is Roche’s Rals TGCM informatics software. To deliver this level of integration, Coyle says, Roche is staying “in step with industry agencies that are just now establishing guidelines for hospital wireless communications” to make sure the company’s future products meet emerging industry guidelines.
Roche also offers a glycemic advisor program for hospitals that are just beginning to implement tight glycemic protocols. The program “connects clinicians, laboratorians, and others with their counterparts from hospitals already successfully using glycemic protocols to improve patient outcomes,” Coyle says. This year, the company plans to customize and improve access to its computerized learning tools.
Nova Biomedical is addressing another need sparked by tight glycemic control protocols: test accuracy and freedom from interferences. The company’s StatStrip glucose monitoring system, Polishook says, avoids accuracy problems such as “erroneous results due to hematocrit or oxygen abnormalities, dosing errors, coding errors, and interferences such as maltose, galactose, acetaminophen, ascorbic acid, and uric acid.” In Polishook’s view, the system “elevates bedside glucose testing to a new level of analytical performance that is comparable to the quality of central laboratory testing.”
The StatStrip system uses a strip technology with four measuring wells rather than one; features a six-second measuring time,1.2-µL sample volume, and color highlighting of abnormal and critical results; and requires no calibration coding. In addition, Polishook says, “StatStrip AccuFil sampling eliminates erroneous results due to overdosing or underdosing of test strips.” Next up from Nova Biomedical, he adds, will be the StatSensor creatinine monitor, a handheld analyzer for whole-blood creatinine testing that, like the glucose system, will feature four measuring wells.
This year, Abbott plans to increase the availability of several recent enhancements to its PrecisionWeb point-of-care data management system. Tama Antonia Donaldson, director of public affairs for Abbott Diabetes Care, says the enhancements include “reports to support tight glycemic control protocols, online entry of manual point-of-care test results, and a remote monitoring system to reduce IT burdens.” Coming down the pike, she reports, is “a new system that is designed to advance test strip performance, support additional analytes, and aid hospitals in meeting the JCAHO national patient safety goals on patient identification.”
HemoCue customers can look forward to the Glucose 201 RT system, which the company will launch shortly, says national product specialist Scott C. Maloff. “A DM version of the RT system is also in the making,” he adds. Like other vendors, he cites smaller sample volume, shorter analysis time, alternative site testing, continuous glucose monitoring, and increased focus on accuracy as “hot topics within the field.”
Finally, International Technidyne Corp., or ITC, continues to offer the IRMA TruPoint portable blood analyzer for bedside use. Hospital senior marketing manager Beth O’Connell says the instrument “goes beyond only glucose testing” and “provides the ability to measure other critical parameters such as blood gases, hematocrit, electrolytes, lactate, creatinine,” and a calculated creatinine MDRD GFR.
CAP TODAY’s survey of bedside glucose testing systems includes products from the manufacturers above and from Arkray and Medtronic MiniMed. Vendors supplied the information listed. Readers interested in a particular product should confirm that it has the stated features and capabilities.
Anne Ford is a writer in Chicago.