Physicians Office Resource - October 2018

Physicians office Resource

2018 Issue 10

™

Resources for You, Your Patients, & Your Practice

NEW STANDARD IN SAFE PATIENT HANDLING Brewer’s Access® High-Low .

Power Exam Table 700 .

Page 2

Take Our Research Survey

also in this issue Strategies Necessary to Achieve Quality Waived Testing

Pg 4

The Role of Six Sigma in a Modern Quality Management Strategy Are You a Tigger or an Eeyore at the Office

.

Pg 34

Pg 16

Get your finger on the pulse of the U.S. Healthcare System and entered for a chance to win an iPad Mini!

Pg 21

1

2018 - Issue 10

Physicians office Resource

PHYSICIANS office RESOURCE

™

Published by Medical Education Resources, LLC

Publisher Aaron R. Medaris amedaris@ physiciansofficeresource.com CEO Andrew C. Nimmo acnimmo@ physiciansofficeresource.com President John D. Pasquale jpasquale@pharmaconnect.com Business Manager Marci J. Hills mhills@ physiciansofficeresource.com

MDescapes: Luxury Destinations & Deals for Physicians

#5200

Account Manager Brandi L. Brower

Four Seasons

Editorial Board Michael Paquin, FHIMSS Barry Craig, MLT (NCA), CLC

22

IN THIS ISSUE

Staff Writer Dylan J. Chadwick

Strategies Necessary to Achieve Quality Waived Testing

Creative Director Production Manager SEO Specialist Keith A. Katsikas Jr

ProductSpotlight

Copyright ©2018

Support more confident patient transfers, more convenient positioning, and unmatched accident protection with Brewer’s Access® High-Low Power Exam Table 700

To continue your free subscription of Physicians Office Resource magazine, please complete the Business Reply Card at the center of this magazine and drop in any USPS mailbox.

From Brewer

Design exclusives help the Access® HLT safeguard your staff and patients like no other power exam table. Including three points of upright contact at the ADA-compliant low seat height; easy-to-operate SafeGlide leg extension technology; an industrybest set of three safety switches; and an industryleading 700 lb. weight capacity.

If you are a manufacturer of medical products or provide services to medical professionals and would like to advertise your products or services to the nation’s top physicians doing in-office testing, call 801-380-6094 or visit: POR.io for more information.

2!

!

Thank you! !

!

™

!

Learn more about this product by entering #5200 at POR.io ! ! ! ! !

The Clinical Laboratory Improvement Amendments of 1988 (CLIA 88) created the concept of waived tests which are defined as...

4

The Role of Six Sigma in a Modern Quality Management Strategy “To err is human…” - a phrase commonly used to attest to the inherent fallibility of humankind.

People make mistakes, and often those mistakes have consequences; large...

16

Are You a Tigger or an Eeyore at the Office?

Most everyone is familiar with A. A. Milne’s characters from The House on Pooh Corner. Eeyore is always down and depressed, moves and...

34

Interested in pricing, product demos, or just want more information?

HERE IS HOW TO GET THE MOST FROM THIS GUIDE 2

4

1

Go to PhysiciansOfficeResource.com

2

Enter the 4-digit product code or name in the search field.

3

Read more about the product, view videos, brochures, white papers, and more.

4

Request additional information, a product demo, or speak with a sales agent, all with just the simple click a button.

3

1 2

Find the Business Reply Card in the issue.

Find and circle the 4-digit code for the product(s) of interest.

...or use this more traditional method POR Information Card for Issue 8, 2017 3800 3801 3802 3803 3804 3805 3806 3807 3808 3809

2

3810 3811 3812 3813 3814 3815 3816 3817 3818 3819

3820 3821 3822 3823 3824 3825 3826 3827 3828 3829

3830 3831 3832 3833 3834 3835 3836 3837 3838 3839

3840 3841 3842 3843 3844 3845 3846 3847 3848 3849

3850 3851 3852 3853 3854 3855 3856 3857 3858 3859

3800 3860 3861 3862 3863 3864 3865 3866 3867 3868 3869

3870 3871 3872 3873 3874 3875 3876 3877 3878 3879

3880 3881 3882 3883 3884 3885 3886 3887 3888 3889

3890 3891 3892 3893 3894 3895 3896 3897 3898 3899

Circle the product #’s that correspond with the items you would like more information on.

First _______________________ MI ____ Last ___________________________ Suffix ______

3

Facility Name __________________________________________________________________

Fill out the rest of the fields on the BRC.

Street _________________________________________________________________________ City _______________________________________________ State ______ Zip ____________ Phone ___________________________ E-mail _______________________________________ Specialty ______________________________________________________________________

4

Drop in any USPS mailbox and a representative will contact you shortly to help answer any questions you have.

Are You Budgeted?

Yes o

No o

Please continue my FREE subscription to (POR) Physicians Office Resource monthly medical digest.

Buying Time Frame: Immediate Purchase o 2-3 Months o 4-6 Months o Over 6 Months o Comments ____________________________________________________________________

3

Signature ________________________________________________ Date ________________

www.PHYSICIANSofficeRESOURCE.com

3

2018 - Issue 10

PHYSICIANS office RESOURCE

STRATEGIES NECESSARY TO ACHIEVE QUALITY WAIVED TESTING

By Irwin Z. Rothenberg, MBA, MS, CLS(ASCP), Technical Writer /Quality Advisor, COLA Resources, Inc. The Clinical Laboratory Improvement Amendments of 1988 (CLIA 88) created the concept of waived tests which are defined as tests that are so simple to perform, and produce accurate results so reliably, as to render the likelihood of erroneous results negligible; and which also pose no reasonable risk of harm to the patient even if the test is performed incorrectly. Thus, these tests are exempt from federal requirements for personnel qualification, training, and competency assessment; quality control (except as specified by the manufacturer), proficiency testing, quality assessment, and the need for routine inspection As a result, laboratory professionals have long expressed concern about the quality of testing performed in these laboratories. This concern has only grown with the rapid proliferation of waived tests, along with point of care /remote testing sites.

Quality Concerns As a response to these concerns, both CMS and the CDC conducted random surveys of waived laboratories several years after CLIA 88 was enacted. These labs had significant quality issues, including the lack of available written procedures; adequate personnel training, quality control performed as 4!

!

!

!

!

!

!

!

required; also, the lack of a proper attention to reagent expiration dates and storage requirements; and the failure to enter test results into electronic medical records. Although not usually specified in the product insert (and therefore not a CLIA requirement), proper documentation and recordkeeping of patient and testing information are also important elements of good laboratory practices.

Among the waived laboratories surveyed, the study also found: • High staff turnover • Lack of formal laboratory education • Limited training in test performance and quality assessment Strategies to Address These Concerns I. Competent Management and Organization To be effective, efforts to achieve quality waived testing through good lab practice must start even before the testing process, all the way back to assessing the laboratory structure, organization, and purpose. These include: A. Commitment to Constant Oversight of the Testing Process !

!

In POLs, this might be a physician or someone in a senior management position who has the appropriate background and knowledge to make decisions about laboratory testing.

B. Anticipating and Addressing Personnel Needs Personnel competency and turnover are important factors affecting the quality and reliability of waived testing results.

While there are no CLIA requirements for personnel performing waived testing, all applicable state or local personnel regulations must be met.

Personnel issues to consider include assessment of present staffing levels and training, to ascertain whether employees have sufficient time and skills to reliably perform all activities needed for testing.

1. Personnel Training Personnel should be trained and competent in each test they will perform before reporting patient results. It is the responsibility of the laboratory director or other supervisory staff to ensure that this training has occurred, along with proper documentation of these efforts.

2. Competency Assessment To ensure testing procedures are performed consistently and accurately, periodic evaluation of competency is recommended, with retraining, as needed, on the basis of results of the competency assessment.

C. Development and Maintenance of Procedure Manuals It is good laboratory practice to develop written policies and procedures so that responsibilities and testing instructions are clearly described for the testing personnel.

Written test procedures also form the basis of training and evaluation of testing personnel. These procedures should be derived from the manufacturer's instructions, and include directions for specimen collection and handling, quality control, test and reagent preparation, and instructions for test performance, interpretation, and reporting.

New testing procedures should be reviewed, signed, and dated by the laboratory director before incorporating them into the procedure manual. The

“Good laboratory practices

can be expanded to include activities to evaluate and improve the quality of waived site testing, utilizing both internal and external quality assessment activities. Results from these assessment activities should be documented and evaluated, noting any irregularities and the actions taken to resolve problems or improve processes or procedures.�

Irwin Z. Rothenberg

manual should be updated as tests or other aspects of the testing service change and should be reviewed by the director whenever changes are made.

When procedures are no longer used, the date of discontinuance should be noted, and they should be removed from the manual. The manual should always be readily available to all testing personnel.

II. Follow Best Practices During Testing

A. The Pre-analytic phase 1. Test orders Confirm that the written test order is correct. If there is a question, check with the ordering clinician before proceeding.

2. Patient identification Use two unique identifiers to ensure D. Maintenance of Complete and accurate identification of the patient Accurate Documents and Records before the specimen is collected. Names Proper documentation is necessary for can be similar and lead to confusion, monitoring and assessing test performance, therefore use birth dates, middle initials, identifying and resolving problems that patient identification numbers or other could affect patient testing, retrieving and means to ensure correctness. verifying information, and maintaining 3. Pretest instructions and information adequate patient and personnel records.

Some tests require special preparation on the Log books or electronic systems can be patient’s part (e.g. fasting), or that the patient used for maintaining and tracking collect the specimen (e.g. urine or stool). information. In some cases, records might Provide the patient with pretest instructions be part of the patient's medical chart. when appropriate, and verify that patients have received and understood the instructions E. Performance of Quality before collecting or accepting the specimen Assessment 4. Specimen collection and handling Good laboratory practices can be expanded The product insert provides details on to include activities to evaluate and improve proper collection, handling and storage the quality of waived site testing, utilizing of patient specimens. Specimens need to both internal and external quality be adequately labeled to prevent mix-up. assessment activities. Results from these Always label specimens as soon as they assessment activities should be documented are collected with pertinent patient and evaluated, noting any irregularities and information. Labeling should also include the actions taken to resolve problems or the date and time of collection and improve processes or procedures. identification of the collector.

5

2018 - Issue 10

PRODUCTFOCUS

Win a FREE iPad Mini!

PHYSICIANS office RESOURCE

As a Thank You for taking part in our brief survey you will be entered in our periodic drawing to win a FREE Apple iPad mini, which you may gift to someone or keep for yourself. The more surveys completed, and the more questions you answer in each, the more chances you will have to win.

www.survey.por.io Additional details on page 21

#5201

Silaris™ Influenza A&B Test From Sekisui Diagnostics

A molecular test utilizing polymerase chain reaction (PCR) technology providing accurate results for early diagnosis and proper management of influenza.

Accurate √ Molecular Results √ State-of-the art microfluidic cassette technology √ PCR test using proprietary OscAR™ Technology

Affordable √ Single Test Diagnosis √ Controls in every kit √ Molecular reimbursement (CPT Code 87502) Simple √ Easy to Use √ Compact portable dock with no calibration required √ Room temperature storage

View Brochures, Videos & More at: POR.io Enter Number 5201 in the Search Area #5202

First Ever CLIA Waived Hematology Analyzer From Sysmex

Faster test results, clinical decisions and greater practice efficiency are coming to physicians’ offices with the first CLIA-waived CBC analyzer. Hematology diagnostics leader Sysmex is bringing more lab testing to the point of care. One of the most common blood tests can be conducted reliably and accurately on-site, in as few as three minutes. The device’s ease of use and innovative technology means in-house staff can operate it in just a few easy steps, without lengthy certification and training. The new Sysmex XW-100 will improve health care efficiency and patient care.

View Brochures, Videos, & More at: POR.io Enter Number 5202 in the Search Area 6

www.PhysiciansOfficeResource.com

CONTINUEDFROMPAGE5 B. The Analytic Phase 1. Quality Control (QC) Quality control provides assurance that the test system has performed as expected, and alerts the user when problems occur which may affect patient results; these can be problems due to operator error, reagent or test kit deterioration, instrument malfunction or improper environmental conditions.

If quality control testing fails to perform as expected, patient testing should not be performed or results should not be reported until the problem is identified and corrected.

QC test results should be recorded and monitored. Records of control results should be periodically reviewed by the person responsible for testing oversight to detect shifts or changes in performance over time which may affect patient results.

2. Test Performance Follow the steps in the test procedure exactly as described in the manufacturer’s product insert and /or the written procedures.

3. Results Interpretation.

Results can be recorded directly in a

patient's chart, in log books, or on a separate report form. Interpretation of the results should be in accordance with instructions in the product insert.

4. Resolving problems If a test result is not acceptable or requires repeat testing (e.g., out of range or invalid), record the initial result, noting it was unacceptable, take steps necessary to resolve the problem, then repeat the test and record the correct result. Good laboratory practice includes recording what happens, whether acceptable or not, and what is done to correct problems encountered during testing. Results should not be reported until the problem is resolved. Follow the steps in the product insert to resolve problems with the test results. If repeat testing does not resolve the problem, contact the manufacturer or technical representative.

reported in a timely manner to the appropriate person. All verbal reports of test results should be documented and followed by a written report. Critical values require immediate notification of the clinician, and procedures should be in place to ensure documentation of these values along with the time of notification of the proper medical personnel.

2. Confirmatory testing The product insert should explain when additional testing is needed to confirm a waived test result or when the test is to be used as part of a multi-test algorithm (e.g. throat culture needed to confirm a negative result for rapid group A strep antigen).

There should be written policies and procedures to ensure that all confirmatory and supplemental testing is performed when needed. When collecting specimens for referral to another laboratory, the instructions provided by the...

C. The Post-analytic phase: 1. Reporting Test Results Patient reports should be legible and

Read this and more articles plus references at www.PhysiciansOfficeNews.com

MICRO SPIROMETER FROM THE WORLD LEADER IN SPIROMETRY • At a list price of only $899, it is the least expensive full spirometer available in the USA • Simple, accurate, rugged and proven Fleisch Pneumotachometer technology • Fully reimbursable (National Average $37 Screening; #5203 $62 Pre-Post BD) in as few as 15 patients • 8.5” x 11” Flow Volume Loop Reports with Interpretation • Optional Accessory Flow Head Extender allows the patient to hold only the flow sensor and the tech securely holds the device, giving a better view of the screen Includes Micro Sp irometer , Flow Hea d Extend USE CODE ‘POR MICRO’ FOR e r, 3L Cal Sy r in g e a n d SPECIAL BUNDLE PROMTIONAL 100 Disposa ble Filter s PRICE* OF ONLY $1275 Retail Va lue $149 5 $220 Sav ings!

*expires December 31st 2018

www.vitalograph.com (800)255-6626

Print Ref: 56045

7

#5204

PHYSICIANS office RESOURCE

2018 - Issue 10

PRODUCTFOCUS

Lab-Accurate Results for ACR and HbA1c From Abbott

With its compact size and panel of tests, the Afinion 2 system is ideal for point-of-care testing in physician offices, clinics, community health centers and hospital out-patient clinics. From just a small urine or fingerstick whole blood sample, lab-accurate results for ACR and HbA1c are made available during the consultation.

View Brochures, Videos & More at: POR.io Enter Number 5204 in the Search Area

Histofreezer® Portable Cryosurgical System From OraSure - Histofreezer

#5205

Histofreezer® Portable Cryosurgical System offers medical professionals an easy and effective method to treat nine different types of skin lesions, including common, plantar and genital warts and other common benign skin lesions. Medical professionals in primary care, internal medicine, podiatry, ob/gyn and dermatology areas of care have either added Histofreezer® to their practice offering or replaced more invasive and less tolerated procedures with Histofreezer®.

View Brochures, Videos & More at: POR.io Enter Number 5205 in the Search Area

#5206

SPOTCHEM™ EZ Chemistry Analyzer From Jant Pharmacal

SPOTCHEM™ EZ chemistry analyzer is a small bench top chemistry analyzer that utilizes dry chemistry technology to test whole blood. Results are available on the SPOTCHEM™ printer or downloaded via LIS. SPOTCHEM™ is ideally suited for small laboratories and physician offices that desire an easy-to-use analyzer with a small footprint. Maximum throughput is 48 tests per hour. Test menu includes 21 tests and 3 panels. Tests whole blood, serum or plasma with rapid results within 4 – 15 minutes.

Extensive CLIA-waived menu, includes lipid panel, creatinine, AST, ALT, glucose, and 2 chemistry panels. Automatic calibration.

View Brochures, Videos, & More at: POR.io Enter Number 5206 in the Search Area 8

www.PhysiciansOfficeResource.com

DON’T GIVE HEART DISEASE A CHANCE.

IDENTIFY CARDIOVASCULAR AND DIABETES RISKS IN ONLY 5 MINUTES The Alere Cholestech LDX® System provides lipid profile with glucose results from a small finger stick sample. n

Lab-accurate, rapid and easy to use

n

CLIA-Waived—no special training required

n

Reimbursed by Medicare and most private payers

Actionable results create immediate coachable moments with patients. See why Alere Cholestech LDX® is the #1 choice

#5207

of finger stick lipid testing by physicians.

TO LEARN MORE, VISIT LDX.POR.IO. © 2018. All rights reserved. Alere Cholestech LDX is a trademark of the Abbott group of companies. Any photos displayed are for illustrative purposes only.

Any person depicted in such photos is a model. CVD141562 10004216 09/18

9

PRODUCTFOCUS Defining Mobile Telediagnostics From MedPod

With the ability to deploy into a medical office in less than 2 minutes, MobileDoc is the ultimate portable practice. Revolutionary in its compact and mobile design, MobileDoc integrates best-in-class professional medicalgrade devices with state-of-the-art HD video and EHR connectivity.

Physicians can provide care remotely that is on par or better than a face-toface visit, including conducting basic exams, checking vitals, and performing specialty testing—shattering the boundaries of traditional care.

PHYSICIANS office RESOURCE

2018 - Issue 10

#5208

View Brochures, Videos & More at: POR.io Enter Number 5208 in the Search Area

#5209

CLIA Waived Molecular Diagnostic Testing From Cepheid

Cepheid’s GeneXpert Xpress® brings standardized molecular testing to any healthcare setting. Employing the highly accurate and easy to use lab in a cartridge technology in every GeneXpert system, the GeneXpert Xpress® is a true on-demand walkaway testing system with a simple test workflow that complements existing laboratory quality and regulatory compliance standards.

Two or four-module configurations save valuable bench space and reduce the need for multiple testing platforms.

View Brochures, Videos & More at: POR.io Enter Number: 5209 in the Search Area

#5210

Accurate, Actionable Results from the Leader in Point-of-Care Lipid Testing From Abbott

The CLIA-waived Alere Cholestech LDX™ Analyzer is engineered for confidence, providing accurate, actionable, and readily accessible results that have set the standard in point-of-care lipid profile, cholesterol, and glucose testing. Results are easy to obtain.

Fingerstick sampling and a small sample size (40μL) makes results less painful and time consuming.

View Brochures, Videos, & More at: POR.io Enter Number 5210 in the Search Area 10

www.PhysiciansOfficeResource.com

If you have one of these...

#5211

...you need one of these.

VITAMIN D PSA

● ●

TSH TESTOSTERONE FREE T4 hCG ●

●

You can feel the exasperation as soon as you see this—we all know patients usually aren’t patient!

No one likes waiting! In fact, long wait times are a major cause of patient dissatisfaction. The FastPack® IP System allows you the benefit of testing in your office and making immediate therapy decisions which can help enhance efficiency and improve outcomes. And that means your patients will be more satisfied — which is good for everyone!

Call us at 800-332-1042 to see how you can improve your work flow and your patient satisfaction.

WWW.SEKISUIDIAGNOSTICS.COM MADE IN THE USA

© 201 Sekisui Diagnostics, LLC. All rights reserved. Because every result matters™ is a trademark of Sekisui Diagnostics, LLC FastPack is a registered trademark of Qualigen Inc.

11

The Doctors Guide to Eliminating Debt From Dr. Cory S. Fawcett

PHYSICIANS office RESOURCE

2018 - Issue 10

PRODUCTFOCUS

#5212

The Doctors Guide to Eliminating Debt can show you how to pay off debt faster than you imagined—including your house. Too many doctors are carrying perpetual debt and giving away a large chunk of each paycheck as interest to the bank. Don’t give away your future to the bank, you earned it, you keep it. Get your cure for Debtabetic Neuropathy and Alzheimer’s Debtmentia before it’s too late.

View Brochures, Videos & More at: POR.io Enter Number 5212 in the Search Area

#5213

Single, Integrated POC Testing Solution From Abbott Point of Care

The fully automated i-STAT System offers a broad menu of tests for diagnostic and treatment indicators related to disease state management and clinical practice guidelines. Using just 2 or 3 drops of blood, the system provides time-sensitive tests at the patient’s side in just minutes.

View Brochures, Videos, & More at: POR.io Enter Number 5213 in the Search Area

#5214

CELL-DYN Emerald Hematology Analyzer From Abbott

CELL-DYN Emerald is a 3-part differential hematology analyzer that offers high performance in an affordable, compact design that provides reliable and accurate patient results every time. As a smaller operating laboratory, you need a solution that offers reliable results. CELL-DYN Emerald provides results in under 65 seconds.

CELL-DYN Emerald’s small size, simple touch screen software and reliability offer an easy-to-use, truly compact table/bench top instrument for easy performance in your laboratory.

View Brochures, Videos & More at: POR.io Enter Number 5214 in the Search Area

12

www.PhysiciansOfficeResource.com

It's flu season

Simplify: workflow, results, patient management.

The BD Veritor™ Plus System for Rapid Detection of Flu A+B simplifies workflow and provides clear and quick results for appropriate patient management within the same visit.

The CLIA-Waived BD Veritor System offers an unambiguous digital result in under 11 minutes*, demonstrated performance compared to molecular tests1, and a low cost of ownership.

• One button functionality, easy to use and implement • Faster test results may improve patient management #5215

Learn more about the BD Veritor Plus System — simply the right POC test for influenza, Group A Strep and RSV.# Request a demo today at bd.com/veritorPOR

*Results after 10-minute incubation period for Flu A+B and RSV; after 5-minute incubation period for Group A Strep # RSV- Respiratory Syncytial Virus References: 1. BD Veritor System for Rapid Detection of Flu A+B, CLIA-waived kit package insert, 8087667 (14) 2018-06.

BD Veritor System for Rapid Detection of Flu A+B, laboratory kit package insert, 8087666 (11) 2017-10.

© 2018 BD. BD, the BD Logo and all other trademarks are property of Becton, Dickinson and Company. BD, 7 Loveton Circle, Sparks, MD 21152-0999 USA Tel: 1.800.638.8663 bd.com

13

2018 - Issue 10

PRODUCTFOCUS

The Brewer Basic Exam Table

PHYSICIANS office RESOURCE

#5216

From Brewer

Full featured, entry-level exam table design. The Brewer Basic Exam Table features a pneumatic cylinder, seamless upholstery, and the largest storage capacity available. We invite you to compare features, price, warranty and you will find the Brewer Basic Exam Table is clearly the best entry level exam table available.

View Brochures, Videos, & More at: POR.io Enter Number 5216 in the Search Area

#5217

Sysmex XN-L™ Series Automated Hematology Analyzers From Sysmex

Now lower volume customers can enjoy the same capabilities in CBC testing as larger hospitals and reference labs. Enhanced clinical value is standard and optional licenses for reticulocyte or body fluid testing are available. The XN-L analyzers are the first to feature BeyondCareSM Quality Monitor, an innovative, web-based QC and calibration management program.

View Brochures, Videos & More at: POR.io Enter Number 5217 in the Search Area

#5218

Rapid, Accurate Screening Method for UTIs From Jant Pharmacal

Accutest® Uriscreen™ is a rapid screening test that combines the detection of both bacteriuria and pyuria (the presence of somatic cells in urine), by detecting catalase activity (an enzyme present in many eukaryotic cells). This easy to use test provides physicians’ offices, clinics, hospitals, labs and long term care facilities with a rapid and accurate screening method for urinary tract infections. CLIA-waived; Requires no instrumentation

View Brochures, Videos & More at: POR.io Enter Number 5218 in the Search Area 14

www.PhysiciansOfficeResource.com

#5219 #5220

#5174

#5175

Call 888-522-9939 or Visit medpod.por.io for More Information 15

2018 - Issue 10

PHYSICIANS office RESOURCE

THE ROLE OF SIX SIGMA IN A MODERN QUALITY MANAGEMENT STRATEGY From Randox Laboratories Ltd

“To err is human…” - a phrase commonly used to attest to the inherent fallibility of humankind. People make mistakes, and often those mistakes have consequences; large and small.

The healthcare industry is no different. In their 1999 report, To Err is Human, Kohn and colleagues estimated that up to 98,000 deaths per year could be directly attributed to medical errors1. This fact, coupled with evidence that around 60-70% of all medical decisions are made based on laboratory results2, shows that consistently accurate laboratory outputs are of paramount importance in reducing risk to patients.

The clinical laboratory plays a crucial role in patient care, and this role is increasingly being shown the recognition it deserves.

Consequently, laboratories are becoming busier than ever before, and with increased workloads, it stands to reason that the rate of error will also increase. Coskun and colleagues maintain that this increased probability of error should be offset with new, innovative solutions aimed at decreasing the risk of error3.

However, before we can develop strategies to reduce the risk of error, we must first understand the potential sources of error.

16

Sources of Error When it comes to laboratory testing, errors are not restricted to the laboratory itself, as they can occur at nearly any stage. The ‘total testing process’ is a multistep clinical process which begins and ends with the needs of the patient4.

It consists of 9 steps: 1. Test selection and submitting a laboratory test request 2. Sample collection (serum, plasma, urine, CSF, etc.)

3. Identification 4. Transport of the sample to the laboratory 5. Sample preparation 6. Sample analysis 7. Reporting test results 8. Interpretation of test results 9. Action Each of these steps has the potential for error, and some steps are more prone to error than others due to increased human involvement5. These steps can be further broken down into 5 phases; Pre-Pre Analytical Phase (Step 1), Pre-Analytical www.PhysiciansOfficeResource.com

Phase (Step 2-5), Analytical Phase (Step 6), Post-Analytical Phase (Step 7), PostPost Analytical Phase (Step 8-9).

To properly quantify and account for potential error throughout the total testing process, it is essential for each laboratory to implement a Quality Management System (QMS). There are many different kinds of QMS, and one of the most popular QMS strategies in the 1990s was that of Total Quality.

Management (TQM). The generic TQM model was based around the PlanDo-Check-Act strategy. First the lab must plan what strategy to implement, and then do it. The next step is to check the data obtained, then act upon the results.

One of the major developments in quality improvement was the implementation of Six Sigma methodologies. Six Sigma was developed by Motorola in the mid-1980s, and since its inception it has been incorporated into many different industries, and has recently risen to prominence in the healthcare sector due to its application in laboratory quality.

What is Six Sigma?

Six Sigma is a method of process improvement which focuses on minimizing variability in process outputs.

Variation in a process leads to wasted time and resources in re-running tests and altering SOP’s etc. Reducing variation will ultimately reduce costs, improve performance and increase profitability. The Sigma model looks at the number of standard deviations (SD) or ‘sigmas’ that fit within the quality specifications of a process.

In the laboratory, the quality specifications relate to the Total Allowable Error (TEa) for each test. The higher the number of standard deviations that fit

between these limits, the higher the sigma score and the more robust the process or method is. As sources of error or variation are removed from a process, the SD becomes smaller and therefore the number of deviations that can fit between the allowable limits is greater; ultimately resulting in a higher sigma score.

conjunction with the Total Allowable Error (TEa). Westgard QC define the TEa as the name given to the limits for both the imprecision (random error) and inaccuracy (systematic error) that are tolerable in a single measurement or test result10. The TEa for each test can be found from numerous sources. CLIA,

Rilibak and Biological Variation (Ricos Goals) provide TEa limits for each test, and are commonly used by labs Six Sigma is a scale, and typically worldwide. Sigma can then be calculated runs from zero to six, though process using the following equation: performance can exceed Six Sigma Sigma = (TEa – %Bias) / %CV providing variability is sufficiently low Where: enough as to decrease the defect rate8.

TEa – Total Allowable Error In the clinical laboratory, a sigma score Bias – The deviation (%) between of three is considered the minimum obtained mean and the reference value acceptable performance, while a score of or peer group target six is considered the gold-standard. A CV – Imprecision of the data (%) test which has achieved Six Sigma performance will experience Example approximately 3.4 errors (out of range A lab is running Aldosterone and wants QC results) per one million QC tests run to evaluate whether it is performing close – showing the accuracy and reliability of to Six Sigma. The lab checks the CLIA a Six Sigma standard test. database, which shows that Aldosterone has a TEa of 36.7%. The lab then How is Sigma Calculated? calculates the %Bias of their Aldosterone In the clinical laboratory, the most assay when compared to their peer common method of calculating Sigma is group, and find that they are running by measuring variation8. The imprecision with a Bias of 5%. The Aldosterone (CV) and inaccuracy (Bias) are routinely assay also has a CV of 10%. Using the calculated for each test, and these metrics above calculation, we can see that: can be used in Sigma calculation, in Sigma = (TEa – %Bias) / %CV 17 Figure 1. Predicting defects using imprecision (CV), inaccuracy (Bias) and total allowable error (TEa)

#5221

OSOM® Trichomonas Rapid Test From Sekisui Diagnostics

The OSOM® Trichomonas Rapid Test is intended for the qualitative detection of Trichomonas vaginalis antigens from vaginal swabs or from the saline solution. The OSOM® Trichomonas Rapid Test is the only CLIA-waived rapid test available today. OSOM® Trichomonas is more sensitive than wet mount due to the assay being able to detect viable and non-viable organisms which offers significant benefits to the patient and clinician alike.

PHYSICIANS office RESOURCE

2018 - Issue 10

PRODUCTFOCUS

View Brochures, Videos & More at: POR.io Enter Number: 5221 in the Search Area

#5222

Hematology Testing Made Easy From Sysmex

Designed for labs testing up to 25 samples per day, the Sysmex pocH-100i™ has the smallest footprint of any analyzer on the market. The instrument requires only 15µL of whole blood for reporting of 17 clinical parameters, including a 3-part WBC Differential. It is ideal for urgent care, physician office lab, small clinic, or any outpatient setting where a point of care CBC is needed.

View Brochures, Videos & More at: POR.io Enter Number 5222 in the Search Area

#5223

Self-contained Diagnostic Workstation From Vitalograph

Vitalograph introduces the Compact Expert diagnostic workstation.

The device is a full touch-screen based medical workstation, which comes equipped with Vitalograph’s flagship Pneumotrac spirometer.

This accurate, robust and linear Fleisch pneumotach produces over 50 spirometry parameters, automatically stores all test data, calibration data and clinical audit trail data in a secure network capable SQL Server database. An intuitive user interface enhances the routine workflow in most practices, allowing quick patient throughput. Beyond spirometry, it is a desktop testing station for ECG, Pulse Oximetry, Weight , COPD assessment, and Blood Pressure measurements.

View Brochures, Videos & More at: POR.io Enter Number 5223 in the Search Area 18

www.PhysiciansOfficeResource.com

CONTINUEDFROMPAGE17 Sigma = (36.7% - 5%) / 10% Sigma = 3.17 In this instance, the Aldosterone assay is running just above 3 Sigma, which is around the minimum acceptable performance. The lab will need to make efforts to decrease their %CV and %Bias to improve the overall Sigma Score for their Aldosterone assay.

What are the Benefits of Sigma?

There are many benefits to incorporating Sigma calculations in your QMS. One of the main functions of Sigma is to give laboratories a quantitative indication of the approximate number of Defects Per Million Opportunities (DPMO). In a laboratory context, this would be the rate of failed QC results per million QC tests run.

As the Sigma Score for a test increases, the approximate number of failed QC results will decrease.

The below graph shows the probability test results will be within acceptable limits in relation to Sigma Score:

Figure 2. Graph showing percentage probability of achieving a result within acceptable limits

According to the above graph, a Six Sigma test will have only 0.2 defects per million opportunities (DPMO). However, it is widely accepted that over time, the Sigma Score of tests will gradually

decrease or fluctuate due to inevitable variability. For this reason, many labs incorporate a 1.5 sigma shift into their Sigma calculations in order to account for any variability over time...

Read the rest of this and other articles at www.PhysiciansOfficeNews.com

MicroLab Spirometer Easy to Use, Affordable, Complete Spirometry The MicroLab spirometer with integral printer and touch screen color display offers easy to use, complete spirometry in an affordable, portable package. ! Touch screen color display ! Choice of child incentives #5224

! ATS/ERS standards compliant ! On-screen test quality prompts

#4975

! Confirming diagnostic interpretation ! Post bronchodilator comparison ! Fast, quiet internal printer ! Low cost disposables ! SPCS PC software optional

www.mdspiro.com Micro Direct, Inc.

803 Webster St., Lewiston, ME

800-588-3381

Fax 207-786-7280

Email sales@mdspiro.com 19

2018 - Issue 10

PRODUCTFOCUS

#5225

Optimize Productivity and Expand your Practice

PHYSICIANS office RESOURCE

From MedPod

The Medpod Medical Cart optimizes productivity and load balancing by enabling access to remote physicians during high volume periods or to reach lowdensity populations. Medpod’s proprietary software integrates with a wide range of professional medical devices and gives the remote provider control of the devices to conduct an examination that is on par with a face-to-face visit. Patient images, audio and data can be captured, annotated, tagged and uploaded in realtime or stored and forwarded into the EHR by either remote or local provider.

View Brochures, Videos & More at: POR.io Enter Number 5225 in the Search Area

#5226

From Routine To Specific Tests, Perform Them All On A Single System From HORIBA Medical

The Pentra C400 is an extremely compact Clinical Chemistry benchtop analyzer. From routine to specific tests, it can perform them all on a single system. It can run up to 420 tests per hour with ISE module. Its automation and continuous loading provides enhanced productivity in a user-friendly environment.

View Brochures, Videos, & More at: POR.io Enter Number 5226 in the Search Area #5227

Now It’s More Than Just A Blood Test From Sysmex

With its simplified operation, the Sysmex XP-300™ is ideal for clinics and physician office labs. It provides a CBC with 17 different parameters, including a 3-part WBC Differential. The XP-300+M combines the accuracy and reliability of a Sysmex CBC with the agility of Medicus Middleware. Features include EMR connectivity, instrument interfaces and a QC module.

View Brochures, Videos & More at: POR.io Enter Number 5227 in the Search Area

20

www.PhysiciansOfficeResource.com

Win a FREE iPod Mini!

Join POR as we conduct our first in a series of brief surveys, designed to give a voice to providers. With your help we can better understand what’s trending in physician offices, laboratories, and healthcare facilities across America, and help improve office and laboratory proficiency, profitability, and patient care.

As a Thank You, we’ll report the results from this and future surveys in Physicians Office Resource magazine. Moreover, we will enter you in our periodic drawing for a FREE Apple iPad, which you may gift to someone or keep for yourself.

The more surveys completed, and the more questions you answer in each, the more chances you will have to win.

www.survey.por.io

21

THE PERFECT Caribbean escape

LIVE LARGE & PROSPER 40% Off Villa Experience Visit FourSeasons.com/Nevis or Call 869-469-6238 Learn more about this resort and take the virtual tour at www.MyMDescapes.com

22

www.PhysiciansOfficeResource.com

25 23

#5228

Accutest pH® Phenaphthazine Paper From Jant Pharmacal

Test papers give instant, easy-to-read results, with clear, bright matches at 0.5 intervals from pH 4.5 to 7.5. Color charts are lab-tested for precision accuracy. Made in the U.S.A. with state-of-the-art materials. An FDA-listed medical test product, used in hospitals and doctor’s offices around the world. Economical – approximately 100 tests/roll. Widely used in hospitals and doctors’ offices to detect the presence of amniotic fluid in vaginal secretions during late-term pregnancy, a sign of premature amniotic sac rupture.

PHYSICIANS office RESOURCE

2018 - Issue 10

PRODUCTFOCUS

View Brochures, Videos, & More at: POR.io Enter Number 5228 in the Search Area

#5229

Make Laboratory Compliance and Inspection Easier From My Inspection

Make laboratory compliance and inspections easier by changing how you document, save and retrieve all information necessary to meet CLIA and accreditation regulations. With two unique electronic tools My Compliance Manual and MyInspection™ Software, the guesswork and tedious task of interpreting and documenting policy, procedure, forms, charts and logs is over. Your lab will be compliant, have less paper, and be inspection ready.

View Brochures, Videos & More at: POR.io Enter Number 5229 in the Search Area

#5230

The Doctors Guide to Smart Career Alternatives and Retirement From Dr. Cory S. Fawcett

The Doctors Guide to Smart Career Alternatives and Retirement will show you ways to redesign your career in healthcare to find that balance of work and enjoyment that’s been missing. Many physicians are ready to give up their healthcare career altogether. It doesn’t have to end that way. There are ways to improve the things you don’t like. We will all eventually leave medicine, when we do, this guide will make it smoother.

View Brochures, Videos & More at: POR.io Enter Number 5230 in the Search Area 24

www.PhysiciansOfficeResource.com

Bionet CardioCare 2000: $1,255.00 Schiller AT-2 Plus: $2,275.00* *add Spirometry: $1,000.00 Burdick ELI 250c: $2,998.00 Welch Allyn CP150 w/ Interp: $3,186.00

#5231

#5232

#5234

#5233

#5236 #5235

#5237

#5238

Coaxial Ophth, Fiber Optic Oto, Speucla Dispenser, Aneroid BP, Wall Transformer & Wall Board without Thermometer: $850.00 with Thermometer: $1,117.00

#5240 #5239

#5241

#5242

#5243 25

#5244

The Brewer Century Series Stool From Brewer

PHYSICIANS office RESOURCE

2018 - Issue 10

PRODUCTFOCUS

Has a pneumatic height adjustment, 16" wide, 4" thick polyfoam seat cushion, and five-leg 23" brushed aluminum accent base. Optional adjustable 18" chrome footing. Optional adjustable contoured backrest with black plastic shroud.

View Brochures, Videos & More at: POR.io Enter Number 5244 in the Search Area

#5245

Memory Loss Biomarkers to Aid in Diagnosis in Primary Care Practices From Evoke Neuroscience

The eVox® System is an FDA 510(k) cleared medical device to aid primary and specialty care physicians in diagnosis of memory loss and other cognitive disorders. eVox® measures memory loss biomarkers that may aid in detecting memory loss sooner, identifying the root cause of memory loss, and performing a differential diagnosis. eVox® procedures are performed in-office and are reimbursable by Medicare and commercial payers.

View Brochures, Videos & More at: POR.io Enter Number 5245 in the Search Area #5246

Micros ES60 From HORIBA Medical

The Micros ES60 is an easy to use tabletop hematology analyzer. It combines the reliability of the current Micros 60 with the latest Linux based operating system utilizing a large color touch screen user interface. The Micros ES60’s Zero Maintenance concept provides unparalleled user convenience monitoring all aspects of instrument operations and provides real time status updates for the user.

View Brochures, Videos, & More at: POR.io Enter Number 5246 in the Search Area

26

www.PhysiciansOfficeResource.com

ADVANCING BIOCHEMISTRY TESTING WITH RANDOX THIRD PARTY REAGENTS

Extensive range of reagents covering over 100 disease markers with 115 reagents, including Adiponectin, Cystatin C and sLDL Cholesterol

Excellent quality and stability producing accurate and precise results whilst reducing the risk of errors and lowering costs

A wide range of kit sizes including Easy Read and Easy Fit options, helping to improve efficiency and cost savings for your laboratory

Automated applications with specialty assays for 195 of the most common clinical chemistry analyzers

Superior methodologies with excellent correlation against gold standard methods, our reagents come in a wide range of formats and methods for any laboratory size

#5247

Not all products are available for diagnostic use in all countries.

Contact us for more information. +13047282890 | TOLL FREE 866 472 6369 www.randox.com | reagents@randox.com Randox Laboratories-US Ltd, 515 Industrial Boulevard, 27 Kearneysville, West Virginia, 25430,

Brewer’s Flex™ Access Exam Table From Brewer

PHYSICIANS office RESOURCE

2018 - Issue 10

PRODUCTFOCUS

#5248

Step up to power table performance for less with Brewer’s Flex™ Access Exam Table. Industry-leading 700-lb. patient weight capacity, unique safety features and unmatched ergonomic patient access maximize your clinical efficiency and ROI. A streamlined footprint and optional upgrades like safety grab bars, stirrups, and passthrough work surface provide ultimate flexibility for your practice.

View Brochures, Videos, & More at: POR.io Enter Number 5248 in the Search Area

#5249

CLIA-Waived Comprehensive Metabolic Panel From Abbott Point of Care

The Piccolo Xpress™ point-of-care chemistry analyzer delivers comprehensive CLIA waived diagnostics to Physician Offices. In 3 easy steps, the Piccolo provides lab-accurate results in minutes from a menu of 29 general chemistry tests, including lipids, liver, kidney, metabolic and other specialty functions. By using only 100 microliters of whole blood, serum or plasma - physicians can make confident treatment decisions faster, thereby increasing the efficiency, throughput and capacity of their practice, while also increasing revenue and ensuring patient satisfaction.

View Brochures, Videos & More at: POR.io Enter Number 5249 in the Search Area

Win a FREE iPad Mini!

As a Thank You for taking part in our brief survey you will be entered in our periodic drawing to win a FREE Apple iPad mini, which you may gift to someone or keep for yourself. The more surveys completed, and the more questions you answer in each, the more chances you will have to win.

www.survey.por.io Additional details on page 21

28

www.PhysiciansOfficeResource.com

#5250

#5251

#5252

#5253

#5254

29

2018 - Issue 10

PRODUCTFOCUS #5255

Fully Automated Quantitive Immunoassay Analyzer

PHYSICIANS office RESOURCE

From Sekisui

The FastPack® IP System is a fully automated quantitative immunoassay analyzer designed for use in the Physician Office laboratory. Utilizing sophisticated chemiluminescence technology, the FastPack® IP System provides the capability to produce complex immunoassay results in 12 minutes or less with a push of a button. Menu includes Vitamin D, Testosterone, TSH, Free T4 PSA and hCG.

View Brochures, Videos & More at: POR.io Enter Number 5255 in the Search Area

#5256

Highly Accurate Networked PC-based Spirometry From Vitalograph

Vitalograph introduces the new Spirotrac V software coupled with the rugged, accurate Pneumotrac spirometer. This accurate, robust and linear Fleisch pneumotach produces over 50 spirometry parameters, automatically stores all test data, calibration data and clinical audit trail data in a secure network capable SQL Server database. An intuitive user interface enhances the routine workflow in most practices, allowing quick patient throughput. Challenge testing, cough testing and slow vital capacity testing with lung age estimation are all standard features. Beyond spirometry, the Spirotrac V also becomes a platform for a PC-based diagnostic workstation, incorporating a Bluetooth ECG, USB Pulse Oximetry, 6 minute walk test, Bluetooth Weight Scale for COPD / CHF assessment, and automated Blood Pressure measurements.

View Brochures, Videos, & More at: POR.io Enter Number 5256 in the Search Area

#5257

Pentra XLR From HORIBA Medical

For laboratories that need a highly reliable hematology analyzer with gold standard technology, the Pentra XLR provides the highest quality of results while delivering process efficiencies with auto-validation, auto rerun, and auto dilutions in a small, compact system. For laboratories that require reticulocytes for better patient care, the Pentra XLR provides a high quality and automated reticulocyte panel, available on a highly reliable hematology analyzer from HORIBA Medical in a cost effective manner.

View Brochures, Videos & More at: POR.io Enter Number 5257 in the Search Area 30

www.PhysiciansOfficeResource.com

Micros ES 60 Hematology System CBC with 3-part diff

Is it viral or bacterial?

Urgent or routine?

Take the guess work out of your day with point-of-care testing!

Advanced technology in a small footprint HORIBA Part # 5360600241

#5258 Pentra 60C+ Hematology System CBC with 5-part diff

Compact 5-part diff system HORIBA Part # 5300001398

#5259 Pentra C400 Chemistry Analyzer

Compact benchtop offering routine to special testing

Why invest in laboratory testing? #5260

HORIBA Part # 5300001388

Because HORIBA’s hematology and chemistry analyzers: • Provide fast and accurate results allowing you to deliver more decisive patient care • Increase office efficiency by reducing call-backs to patients with test results • Increase patient satisfaction by eliminating wait time for results and repeat office visits

Get Connected!

The LiteDM Data Management System: • Provides an affordable way to connect up to four analyzers • Eliminates transcription errors by consolidating results to one report • Streamlines operations by connecting directly to EMR systems

PROMOTION*

Lite

DM V3

Easy • Patient Data Management

Contact us at: 888-280-1401 email us at: medical-marketing.US@horiba.com

Purchase* a HORIBA Micros 60 hematology analyzer with LiteDM and receive the following: • Two LiteDM connections at no additional charge AND • A six month extension on analyzer service OR • A two-year program agreement * Promotion ends December 31, 2018

Contact your HORIBA Medical Representative for more information • www.horiba.com/us/en/medical/

31

2018 - Issue 10

PRODUCTFOCUS #5261

Portable, Single Click Operation Spirometer From MicroDirect

PHYSICIANS office RESOURCE

The Micro Direct SpiroUSB many features include single click operation of all main functions, full ATS/ERS test quality checks, real time Flow/Volume and Volume/Time traces, a choice of child incentive displays, choice of predicted values, estimated lung age, pre/post bronchodilator comparisons and can be used on multiple PC’s with dongle software protection key. The child incentive display and ATS quality checks ensure maximal results every time. Use with a laptop for true portability.

View Brochures, Videos & More at: POR.io Enter Number 5261 in the Search Area

Ramp® 200 Cardiac Test System

#5262

From Jant Pharmacal

RAMP® 200 Cardiac Diagnostic System tests for NT-proBNP*, Troponin I, CK-MB and Myoglobin. Compact, high throughput, multi-port laboratory reader (18-36 tests/hour with 3 test modules). Run multiple tests on the same or different patients simultaneously. Enhanced data management and connectivity.

Self-diagnostic and internal quality control checks. Single Port RAMP reader is also available. Results in 15 minutes. *Entresto, a new drug for HF, disrupts BNP levels, however NT-proBNP “remains a useful cardiac biomarker to assess therapeutic effect and prognosis in patients treated with the drug.” References available. Entresto is a TM of Novartis AG.

View Brochures, Videos & More at: POR.io Enter Number 5262 in the Search Area #5263

The RX imola From Randox

A fully automated, random access analyzer with STAT sampling functionality; boosting productivity and saving time when it matters most. Developed for medium-high throughput laboratories, the RX imola provides comprehensive testing with the world-class RX series test menu, including specific proteins, lipids, therapeutic drugs, drugs of abuse, antioxidants and diabetes testing. The RX imola: A cost-effective system that delivers consistent high quality results with a small footprint.

View Brochures, Videos & More at: POR.io Enter Number 5263 in the Search Area 32

www.PhysiciansOfficeResource.com

#5266

#5264

#5267

#5265

Exam Tables

#5268

#5269

#5271

#5270

Pediatric Tables

#5272

#5273

#5274

#5275

Power Tables

#5276

#5277

#5278

#5279

Cabinets and Stools

#5280

#5281

#5282

#5283

33

2018 - Issue 10

PHYSICIANS office RESOURCE

ARE YOU A TIGGER OR AN EEYORE AT THE OFFICE?

By Dr. Cory S. Fawcett,

Most everyone is familiar with A. A. Milne’s characters from The House on Pooh Corner. Eeyore is always down and depressed, moves and talks very slowly, thinks everything is bad and getting worse, and drags everyone down with him. Tigger, on the other hand, is always the life of the party, he is constantly smiling, moving and talking rapidly, dancing and jumping and bringing everyone’s attitude up a notch. Tigger is fun, fun, fun, fun, fun. If you asked each of your office staff which one of these two characters best describes you, what would they say? Is that the answer you want to hear?

How do you feel when you walk into an office and are greeted by a receptionist with a big smile, a happy face and a cheery attitude?

34

How do you feel when you walk into that same office but are greeted by a receptionist who is frowning, grumpy and mean?

I bet I know which of these receptionists you would choose to greet the patients in your office.

Your attitude goes a long way toward setting the tone in your office. If you are grumpy, your office staff will be grumpy also. If you are happy and upbeat, you will pull those you come in contact with up with you. So which do you want; an upbeat office or a grumpy office? Which do you have now?

I worked with a physician who alternated between these two personality types. Everyone in his office was on pins and needles each morning waiting to see www.PhysiciansOfficeResource.com

which personality he would have that day. One day he would walk into the office and be your best friend, shaking hands, patting backs, asking how your family is doing, and the entire office would perk up. The next day he could come in so grumpy that no one wanted to be near him. His attitude in the first two minutes after walking in the door would set the tone of the entire office for the rest of the day.

In a service business, you can’t afford to be an Eeyore. Patients will not want to come back to see you, they will not say good things to their friends who might need your services, they will be more likely to sue you if something goes wrong, and they will not leave you a good online review. OUCH! Patients love the doctor who is more like Tigger. Tigger rubs off on everyone immediately. Patients are happy to see you, they tell their friends what a great doctor you are and how great your bedside manner is, they send you referrals and when they take the time to write an online review, it will be a good one. People are much more likely to leave Eeyore

“ Smiling causes those around you to smile. It is an instant pick me up.

Frowning is also contagious, it will causes others to frown. Test it out.

Smile at someone and see if they smile back.”

Dr. Cory S. Fawcett

a bad review, than to leave Tigger a good review. Bad news travels faster.

The office staff feel the same effects. No one wants to work with Eeyore. It’s hard enough to have to put in a long day at work without having to contend with a cranky or gloomy doctor. The things you say and do set the tone for the entire office and that mood lasts the entire day. Tigger is unlikely to be labeled a disruptive physician, as long as he is not bouncing off the ceiling.

I recently wrote an article about the importance of smiling, how contagious it can be and how it affects everyone nearby. You can read it here: https://drcorysfawcett.com/ a-smile-can-change-everything/ Smiling causes those around you to smile. It is an instant pick me up. Frowning is also contagious, it will causes others to frown. Test it out. Smile at someone and see if they smile back.

Before you walk into the office next time, stop outside and take a few deep breaths. Let go of all the things that are bothering you and leave them outside. Put a big smile on your face and open the door as Tigger.

Your office staff will be so happy you did. Just don’t bounce too high.

Find more helpful information from Dr. Cory S. Fawcett by following his blog, Prescription for Financial Success, at DrCorySFawcett.com or by reading his books in The Doctors Guide Series.

Read this and other articles at www.PhysiciansOfficeNews.com 35

2018 - Issue 10

PRODUCTFOCUS

Win a FREE iPad Mini!

PHYSICIANS office RESOURCE

As a Thank You for taking part in our brief survey you will be entered in our periodic drawing to win a FREE Apple iPad mini, which you may gift to someone or keep for yourself. The more surveys completed, and the more questions you answer in each, the more chances you will have to win.

www.survey.por.io Additional details on page 21

Lightweight Handheld Spirometer From Vitalograph

Vitalograph’s In2itive combines the benefits of full spirometry, data integration and mobility in a small lightweight handheld spirometer.

The In2itive features flow measurement with the robust, industry leading accuracy of the Fleisch pneumotach. The spirometer can store over 10,000 patients in memory, archive to a MicroSD memory card or synchronize seamlessly with the new Spirotrac V spirometry software. Printing is accomplished by quickly downloading to the included Vitalograph Reports software or via an optional accessory print cradle directly to standard office printers. The In2uitive has a color touchscreen featuring audible graphic incentives. Portability is enhanced with full day rechargeable battery life. A unique aspect of the product is a convertible flow head, which can either be mounted directly on the top of the device or separated to allow it to be held by the patient while the technician holds the device.

#5284

View Brochures, Videos & More at: POR.io Enter Number 5284 in the Search Area

#5285

The RX daytona+ From Randox

A bench-top, fully automated, random-access chemistry analyzer, providing routine and specialized testing with emergency STAT sampling functionality. Demonstrating unparalleled versatility, the RX daytona+ combines robust hardware and intuitive software with the world-class RX series test menu, including specific proteins, lipids, therapeutic drugs, drugs of abuse, antioxidants and diabetes testing. The RX daytona+ ensures unrivalled precision, reliability and accuracy for results you can trust.

View Brochures, Videos & More at: POR.io Enter Number 5285 in the Search Area 36

www.PhysiciansOfficeResource.com

INNOVATIVE INTEGRATION ACROSS THE CARE CONTINUUM

CBC testing solutions for physician office labs

#5286

#5287

#5288

FREE SERVICE*

XN-L SERIES

Service included at no additional charge with purchase of analyzer. * Promotion available for a limited time on the XN-330 and XN-430 models.

Terms and conditions apply.

Contact your Distribution Representative for additional information and promotions.

www.sysmex.com/us © 2018 Sysmex America Inc.

37

#5289

Drugs of Abuse Testing and Routine Chemistry Panels on a Single Analyzer From Carolina Liquid Chemistries

PHYSICIANS office RESOURCE

2018 - Issue 10

PRODUCTFOCUS

Carolina Liquid Chemistries Corp. announces the successful launch of Medica Corporation’s high-speed benchtop analyzer, the EasyRA®.

The updated analyzer now operates at a photometric rate of up to 240 tests per hour or up to 480 tests per hour with ISE. The EasyRA urine drug screening and general chemistry reagents are CLIA categorized as moderately complex. This all-in-one system allows clinical laboratories to screen for drugs of abuse in urine while also allowing healthcare providers to assess routine chemistry panels on a single analyzer.

View Brochures, Videos & More at: POR.io Enter Number 5289 in the Search Area

#5290

The NanoEnTek FREND Immunoassay System From NanoEnTek

The NanoEnTek FREND Immunoassay System provides Vitamin D, TSH, fT4, PSA, and Testosterone results in minutes with a nocost placement program. Complete all 5 tests in less than 20 minutes for same visit patient consultation. PSA and TSH results are available in 3 minutes or less. Imagine having a new source of revenue with improved practice efficiency and patient satisfaction. Thoughtfully designed, with your practice in mind.

View Brochures, Videos & More at: POR.io Enter Number 5290 in the Search Area

#5291

EZ 2-Part Reagent Vitamin D From Carolina Liquid Chemistries

Carolina Liquid Chemistries Corp., also known as The Reagent Company, has recently added to their menu the EZ Vitamin D assay. The EZ Vitamin D Assay is the first and only 2-part, latex enhanced immunoturbidimetric assay for use on automated chemistry analyzers. It is FDA Cleared, recognizes both 25-OH Vitamin D2 and D3 equally, and is a 20part (R1 and R2) liquid ready to use reagent with no sample pretreatment required.

View Brochures, Videos & More at: POR.io Enter Number 5291 in the Search Area 38

www.PhysiciansOfficeResource.com

AMH Total βhCG (5th IS) DHEA-S Sensitive Estradiol Unconjugated Estriol hFSH

hLH

Inhibin A Progesterone Prolactin SHBG Testosterone

A COMPREHENSIVE MENU TO ANSWER LIFE’S REPRODUCTIVE CONCERNS Two new reproductive assays provide you with more options for testing.

Our comprehensive menu of reproductive immunoassays helps to support healthcare for men, women and children. Our newest reproductive health assays, Access AMH and Access Sensitive Estradiol, support global fertility assessment and hormone monitoring.

› Access AMH, the only automated AMH assay to use a human recombinant antigen, delivers consistent and dependable results for assessing ovarian reserve

› Access Sensitive Estradiol assay has the broadest measuring range, surpassing IVF guidelines for hyper-response, in addition to offering pediatric reference ranges

› Access 2 immunoassay system, a powerful and reliable benchtop analyzer, features a space-saving design and user-friendly features

Learn more at beckmancoulter.com/reproductive

#5292 © 2018 Beckman Coulter, Inc. All rights reserved. Beckman Coulter, the stylized logo and the Beckman Coulter product and service marks mentioned herein are trademarks or registered trademarks of Beckman Coulter, Inc. in the United States and other countries.

For more information, visit www.beckmancoulter.com/contact.

AD-103964 For distribution only in the following region(s): U.S.

39

Flu, RSV, Strep.

Be Ready. #5293

With confirmatory molecular results,

Cepheid’s CLIA Waived test menu delivers peace of mind to you and your patients.

Xpert® Xpress Flu/RSV • One sample. One Cartridge. Three results • Qualitative, molecular detection and differentiation of influenza A, influenza B and RSV • No confirmation required for negative results

Xpert® Xpress Flu

Xpert® Xpress Strep A

• Qualitative, molecular detection and differentiation of influenza A and B

• Accurate, real-time PCR molecular testing

• Sample types include nasal swab and nasopharyngeal swab

• Internal QC in each cartridge

• No confirmation required for negative results

for Group A Strep

• No confirmation required for negative results*

For more information, call (888) 256-6990.

For in vitro diagnostic use. * No culture confirmation required for negative results unless clinical symptoms persist, or there is an outbreak of acute rheumatic fever (ARF).

40

904 Caribbean Drive | Sunnyvale, CA 94089 USA |

TOLL FREE

+1.888.336.2743 |

PHONE

+1.408.541.4191 |

FAX

+1.408.541.4192 | www.cepheid.com

www.PhysiciansOfficeResource.com