2017 POCT Safety Net Clinic Laboratory Package Winners
Downtown Clinic, Laramie Wyoming
The Downtown Clinic is just that – a downtown clinic in the college town of Laramie WY that has close ties with both the community they serve and the local university. The clinic has five paid staff and many volunteers. Their medical director is on faculty at the university, the local community provides dinner for the staff every Wednesday evening and the clinic draws on the student population for many of its volunteers. The clinic also includes a community vegetable garden, providing produce for their clients in season. They make an important distinction in referring to “clients” rather than patients, as they consider themselves partners, collaborating on health issues together. The clinic is currently not performing testing on-site and clients must travel 2.4 miles to get labs drawn. In a town with an inhospitable climate and no public transportation, that makes lab compliance a constant challenge. The Downtown Clinic should clearly benefit from on-site POC testing.
Community Health Services of Union County, Monroe NC
This is a diabetes clinic serving about 3500 uninsured patients in the Charlotte, NC suburbs. They will soon be expanding into general health care. They expect to add 15-20% patient volume and will also greatly benefit from expanded on-site laboratory testing at that time. This clinic states that they would be an educational laboratory, providing training for Wingate University healthcare students. The clinic already experiences frequent delays in care due to inability to contact patients, with 25% of contacts unsuccessful on the first attempt. They serve a significant number of undocumented immigrants in their practice, who are frequently unwilling to give accurate phone numbers out of fear. The immediate intervention made possible by POC laboratory testing would decrease the number of emergency room visits by their patients, driving down overall healthcare costs. This clinic is already providing very good medical care which can be improved significantly with the addition of on-site laboratory testing.
Free Clinic of Franklin County, Rocky Mount VA
The staff at this clinic (two paid staff, the rest volunteers) was very passionate about the benefit their clinic would derive from real-time results in a POC laboratory. They currently send all patients to the local hospital with an average turnaround time of about 72 hours. Tracking patients down once results are received is frequently problematic and clinicians are sometimes treating based on their “best guess”. One of the nurse practitioners gave the example of a time she saw a patient in the clinic and learned three days later that she had a 5.9 gm hemoglobin! At times, local law enforcement has been called in to help track down a patient. This clinic also provides a program of Diabetes Education classes to their patients. Due to cost, they are unable to send all participants out for A1c testing and are using metrics such as BMI and blood pressure to measure effectiveness in some cases. The ability to perform a pre-and post-A1c and lipid profile would be a much more reliable measure of long-term improvement for their participants.