Making impact in POCT amongst the Andes

Well into spring, during a sunny November day in Santiago, Chile, Association for Diagnostics & Laboratory (ADLM) Latin America Subcommittee members Juan David Garcia, DCLS, MBA, and Alejandro Molinelli, PhD, NRCC-CC, FADLM, met Carolina Prieto, MD, during the Roche-sponsored ADLM point-of-care testing (POCT) workshop.

Prieto is a clinical laboratory specialist who works at a hospital in Santiago as medical director. Motivated by point-of-care (POC), she also serves as POC pilot representative in an active aging program in the south of Chile. She’s deeply committed to improving access to high quality diagnostic services – especially in rural areas.

Santiago, a metropolitan city nestled amongst the Andes, offered mountain views, vineyards, culinary delights, and travel adventures. But it also welcomed ADLM for a workshop supporting the integration of POCT into the health care system.

When Prieto learned about ADLM’s workshop on POCT, she knew she had to be there. The opportunity caught her attention since she followed new developments and innovations in the field. Daily, she and her colleagues struggled with the lack of standardized quality management, long turnaround times for results, insufficient lab oversight, and still-developing accreditation frameworks in Chile. Moreover, POCT is often not available in rural areas. She hoped the presentations at the workshop would cover those issues.

Furthermore, the event was a chance to receive more education on the topic and collaborate with other attendees and colleagues. Prieto wanted to strengthen her knowledge, understand best practices, and connect with leaders in POC.

One thing on Prieto’s to-do list was wanting “to ensure that the systems [they] promote truly benefit the patient and [are] also supported by strong quality framework and competent professionals.” She hoped that the workshop would answer this question and touch on the other setbacks that her and her colleagues face. She emphasized that many laboratory specialists need to be involved in facilitating positive change.

On November 4th, Prieto, along with 35 other attendees including laboratory medicine professionals, hospital leaders, and government representatives, gathered at the workshop, “The role of POCT testing in the diagnostic process: Clinical and operational implications.” Seated at round tables, attendees engaged with Garcia and Molinelli on the subject of POCT. The speakers covered not only the devices but also the systems. They offered an understanding of how the devices could support established testing practices rather than replacing them.

The day concluded with hands-on, collaborative exercises and applications of POCT that allowed them to apply knowledge. Prieto was excited about the content and the exercises, and was anxious to see how the recommendations worked in the lab.

While the workshop left Prieto inspired, she knew that much work remained ahead. And energized by the information, she returned to her hospital.

 Prieto worked to apply the new thinking in an archipelago 600 miles south of Santiago named Chiloe. This region of Chile is rural and ideal for the integration of POC applications. Since the workshop, Prieto reached out to a vendor in Chiloe to train staff to lead application of the ideas in her hospital. She has further plans to meet with leaders at one of Chiloe’s healthcare systems to discuss increasing the use of POCT on the islands.

In workshops like these, exchange goes both directions. Prieto and her colleagues were able to involve the ADLM speakers in discussions that would affect their profession. By luck, the day after the event was the Chilean Society of Clinical Laboratory Medicine’s (SMLC’s) annual congress and Garcia and Molinelli were able to attend. They met other leaders in the field and learned about the country’s successes and challenges and ongoing efforts in laboratory medicine.

Prieto has high hopes for the future: she envisions POC fully integrated into laboratory systems, more harmonization from the vendor, investment in education and certificates, and more workshops that solidify the training of professionals in the field. But more than this is her belief in the importance of people connecting laboratorians to professional outside labs in hospitals, the government and the community.

Developments in technology, innovation and education are important, albeit overwhelming — but with Prieto’s goal in mind they can help keep focus on what the patient truly needs.