Point-of-care lab technology speeds up bloodwork

A made-in-Canada lab technology – the epoc point-of-care blood analysis system – has been helping hospitals around the world care for patients on ventilators, many of whom needed special attention because of the COVID-19 pandemic.

And thanks to its small size and portability, the system is becoming increasingly popular with community physicians and paramedics too, who use it to conduct on-the-spot blood analysis of their patients.

Siemens Healthineers acquired the developer of the technology, Ottawa-based Epocal Inc., in 2017. In early 2021, Siemens announced an investment in the company, adding two new manufacturing lines and an additional 24,000 square feet to meet increased demand for the point-of-care business across Canada and worldwide.

The Ottawa-based business unit now supplies the device and the test cards to more than 70 countries with the help of Siemens Healthineers’ global sales and service teams.

“We saw a large and very rapid increase in demand that we were able to respond to, thanks to our team of passionate employees, significant investments during the pandemic and very stringent COVID protocols that allowed us to expand the site and increase output, said Mathias Ganzmann, general manager, Siemens Healthineers POC Ottawa.

The use of a mobile device for blood testing isn’t surprising given the increasing use of mobile devices for banking, booking vacations and so many other applications, added Ganzmann. “When you’re a physician caring for a patient in a life and death situation, you want to have the answer right away. You don’t want to wait for hours or days for blood test results.”

The epoc blood analysis system measures blood gases, metabolites and electrolytes, including oxygen and carbon dioxide, sodium, potassium, ionized calcium, chloride, glucose, lactate, blood urea nitrogen, creatinine and hematocrit with accuracy and actionable information that is equal to or better than traditional blood testing technologies, said Vargha Talebi, Siemens Healthineers’ director, Assay Systems R&D.

Aside from hospital ICUs, the epoc blood analysis system is popular with both land-based and air ambulance paramedic services. The Sudbury Paramedic Service, for example, has four devices that are used to provide early intervention home care for older adults at risk of hospital readmission for complications related to Chronic Obstructive Pulmonary Disease (COPD) and heart failure.

Sudbury’s Community Paramedicine Program began in 2015 with two paramedics and now includes 20 to 24 paramedics staffing a Care Transition Program for older adults released from acute care, a High-Intensity Needs Program for the most critical patients requiring near daily interventions, and a Community Paramedicine Long-Term Care Program caring for patients on a waiting list for congregant care and at risk of Emergency Rooms (ER) visits or hospital admission.

According to Sudbury advanced care paramedic Marc Ungar, the epoc blood analysis system is used on average once daily during scheduled and just-in-time calls to monitor and stabilize patients, avoiding 911 calls, ER visits and hospital admissions.

In the absence of point-of-care testing, said Ungar, a physician would have to requisition a blood test at a community lab, resulting in a delay of up to two weeks and a requirement for the patient to leave home or pay the community lab for a blood draw at home.

The epoc blood analysis system is also ideal for physician offices and clinics in remote communities unable to wait days for blood test results from centralized labs.

“The device can work with arterial blood, venous blood or capillary blood,” said Talebi. “For arterial or venous blood, it’s a standard blood draw that is taken, and for capillary blood, it’s a finger lance. The blood is collected in a sample collection device – a syringe or a capillary tube – and injected into a credit card size test card containing a smart sensor and assay panel with all of the micro fluidics required for the actual panel workup.

“The sample travels through the micro fluidics channels across our assay panel, which is inserted into the hand-held device, and in two or three minutes, you have your results on the device’s mobile high-definition display.”

In addition to the advantage of providing test results in minutes, the system requires a very small sample draw of less than 0.1 ml of blood, said Talebi.

The test cards can be stored at room temperature and are bar-coded with a lot number and expiration date for quality assurance, preventing use of an expired test card.

The slim, lightweight design of the hand-held device includes a Vibrant HD Touch Screen – HD that can be used with gloved fingers and features a large onscreen keyboard. Both audio and visual prompts guide users during the test process, informing them, for example, when to inject the sample and insert the test card into the device.

The colour-coded results on the display tell the user at a glance if a result is normal, outside the reference range, or critical.

The wireless, battery-operated device is ruggedized for use in land-based and air ambulance settings, and both stores data internally and transmits results to hospital information systems.

One of Siemens Healthineers’ most mature markets based on installed base and market penetration is the U.S., but Ganzmann projects continued acceptance of the epoc blood analysis system globally, noting that like any new technology, “You first have to build trust. You have to be at the customer site to explain your technology and let people experience it. Then you need some word-of-mouth communication. That’s where we are right now in Canada.”

Siemens Healthineers is continuing to invest in its epoc blood analysis system. “We have a very active research and development department here in Ottawa and we are actively working on the next generation of our product,” said Talebi.

“I can’t say too much about it for obvious reasons, but we are adding functionality that will see our epoc system grow to include other medical applications such as kidney disease, heart failure, diabetes, hemorrhage, chemical poisoning, shock and sepsis, among others.”

According to Ganzmann, point-of-care blood testing in no way represents a threat to centralized labs, which have more testing capabilities. “Point-of-care blood testing is more of a complementary solution,” he notes.