Blood gas testing: an interview with David Stein, PhD, CEO, Point of Care, Siemens Healthcare Diagnostics

Interview conducted by April Cashin-Garbutt, BA Hons (Cantab)

insights from industryDr. David SteinCEO, Point of Care Business Unit,
Siemens Healthcare Diagnostics

What are blood gas tests, and when are they requested?

The industry term ‘blood gas testing’ has come to mean the accurate measurement and reporting of a wide menu of blood parameters, all on a single platform.

The latest Siemens Healthcare Diagnostics blood gas systems deliver results for pH, blood gases, electrolytes, metabolites, CO-oximetry, and a variety of calculated parameters.

Rapid reporting of all of these measured and calculated blood gas parameters can help physicians to improve patient care and outcomes and save lives.

Can you give a brief history of blood gas testing at Siemens?

Siemens and its predecessor companies have helped to shape both how and where modern blood gas testing takes place, starting with the introduction of Corning Glassworks’ first pH glass electrode in 1964.

In 1968, Corning Medical launched its first blood gas analyzer for pH, pO2, and pCO2, and through 1985, a series of new-product introductions saw the company become one of the dominant clinical blood gas/electrolyte players worldwide. The design, technology, and product attributes of blood gas instruments were carefully honed to meet customer needs in the hospital marketplace.

In 1985, Corning Medical formed a joint venture with Ciba Geigy, creating Ciba Corning. Advances in gas-sensor technology, along with allied advances in ion and metabolite sensors, resulted in the introduction of integrated testing platforms that maintained Ciba Corning’s blood gas system leadership position into the early 1990s.

In 1995, Ciba Geigy took 49.9% ownership of Chiron Corporation, a leading biotechnology company based in California. Part of the payment was satisfied by the acquisition by Chiron of the Ciba Corning diagnostics business, and Chiron Diagnostics was born.

In 1998, Bayer Healthcare Diagnostics purchased Chiron Diagnostics, forming what was at that time the world’s fourth-largest clinical diagnostics company. The 1990s marked the introduction of new, purpose-designed testing systems with extended menus, compact platforms engineered for low cost, and the first information-management solutions to support the beginning of the migration of blood gas testing toward remote point-of-care (POC) sites.

Developments in blood gas testing progressed throughout the following decade. Easier-to-use cartridge-based systems with automatic quality control (AQC) were launched. System throughput improved, and data-management solutions evolved.

In 2007, Siemens purchased Bayer Healthcare Diagnostics, and since then, we have continued to advance clinical utility and improve the workflow of blood gas testing. For example, our latest blood gas systems provide lactate and bilirubin tests, accept pleural fluid and dialysate samples, integrate bar-code scanning, support wireless connectivity, and much more.

How has blood gas testing changed in recent years?

Until relatively recently, blood gas testing was largely centralized and performed by skilled technicians in the main hospital laboratory. Now, facilitated by many of the platform, assay/reagent, and ecosystem developments Siemens has pioneered, testing has evolved away from the central lab and closer to the patient into a multitude of critical-care locations.

Our blood gas POC testing (POCT) solutions have driven this migration through the positive impact they have made on patient workflow and improved medical outcomes.

Blood gas tests can now be run by hospital nurses and doctors, where and when they are needed most, helping to make an immediate difference in respiratory therapy, labor and delivery, the ICU, the OR, and the ED.

What other factors need to be considered when designing a blood gas testing system?

Siemens continues to create blood gas solutions to meet the testing challenges of the future. Recent surveys have shown that our customers want test systems that have lower cost of operation and provide improved clinical value through expansion of the test menu, reduced sample-size requirements, and reduced maintenance, as well as expanded connectivity to include wireless and open systems.

These are the drivers behind the cost-reduction platforms Siemens will be introducing over the next few years.

How important is proper sample collection and handling in blood gas analysis?

Good sampling technique and proper sample handling are very important in quality blood gas testing. Poor sample draw or improper handling can lead to questionable results or worse: clotted samples that are unusable. It is estimated that preanalytical errors account for 45.5% of the errors in laboratory medicine.1

What do you think the future holds for blood gas testing?

Customers increasingly want end-to-end harmonization—the delivery of concordant results across different measurement technologies, including central laboratory and point-of-care environments.

This is important, since critical-care testing may be performed in many different locations throughout a hospital. For example, Siemens offers a selection of blood gas analyzers designed for the specific requirements of different areas and departments, including the RAPIDLab® 348EX Blood Gas System used in low-volume settings, the mid-volume RAPIDPoint® 500 Blood Gas System, and the high-volume RAPIDLab® 1200 Series Blood Gas Systems.

It is imperative that harmonization exist across these Siemens blood gas systems. Harmonization helps to ensure that the same clinical decisions are made for the patient, regardless of which Siemens blood gas system performed the test and where, so that appropriate and consistent therapeutic actions are administered.

End-to-end harmonization is a key pillar our POCT strategy as our portfolios evolve.

What are Siemens’ plans for the future?

Siemens will maintain and develop its industry leadership position in blood gas testing in particular—and in POCT overall—through the continued development of customer-centric solutions that advance clinical value, utility, and convenience, and through pioneering additions to our POCT portfolio.

For example, the latest enhancements to our RAPIDComm® Data Management System—including mobile-device access, operator training and competency management with PEP/PEP Administrator integration, and device management of hundreds of remote, connected platforms—will help blood gas customers to establish and maintain healthier POCT ecosystems.

They are key Siemens enablers in the delivery of cost-reduction platforms, optimal patient care, compliance assurance, and the maximization of efficiency—from wherever in the hospital POCT data originates.

With the RAPIDComm Data Management System, we are uniquely differentiating our POCT proposition. The RAPIDComm Data Management System doesn’t just support blood gas testing on RAPIDLab and RAPIDPoint systems; it also provides POCT coordinators with scalable connectivity to oversee, control, manage, and troubleshoot Siemens urine chemistry and diabetes-care analyzers.

In addition, we are focusing on improvements in the performance and utility of POCT devices. Siemens is also taking into consideration the core needs of POCT coordinators: We are helping to improve the control, effectiveness, and productivity of their POCT programs.

Siemens’ differentiating ecosystem approach will better accommodate the various challenges POCT is facing today, and it will contribute significantly to our growth in the future. The RAPIDComm Data Management System is already addressing the industry impediments of POCT integration and will move toward even more-open POCT data-management and systems oversight in the future.

Where can readers find more information?

More information about Siemens blood gas solutions can be found at http://www.healthcare.siemens.com/point-of-care.

About David Stein, PhD

david steinDr. David Stein was appointed CEO of the Point of Care Business Unit for Siemens Healthcare Diagnostics in January 2011. He is responsible for long-term global strategy and business planning, strategic marketing, product and brand management, product development, and operations for all existing and new POC products and solutions.

David previously held the position of Vice President of Engineering within Siemens Healthcare Diagnostics, leading and directing engineering activities for several central lab, point-of-care, and informatics products. He joined Siemens in 2001 and, through positions of increasing responsibility in product development, business operations, and portfolio strategy, has directed development and strategy for a number of successful products in the Siemens Healthcare Diagnostics portfolio.

Dr. Stein holds a PhD in engineering from The Johns Hopkins University.

Reference

  1. Ross JW, Boone DJ. Assessing the effect of mistakes in the total testing process on the quality of patient care [Abstract 102]. Martin L Wagner, W Essien JDK eds. 1989 Institute of Critical Issues in Health Laboratory Practice 1991, DuPont Press, Minneapolis, MN.

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