Many patients and providers rely heavily on glycated hemoglobin (HbA1c) values to determine adequacy of care in diabetes. This value can be checked as often as every 3 months for ongoing management. Previously, this was only available by venipuncture, which required a second step: Get the lab before the appointment to allow for discussion of the results at the patient visit. To achieve this, the lab would need to be ordered in advance of the patient’s visit or, alternatively, during the appointment, thereby leaving you without access to the results during the face-to-face appointment, meaning you or your office staff would have to follow up with the results. Furthermore, this may have not been completed as it was often lumped in with fasting lab, which may delay or prevent the person from getting the labs completed due to schedule challenges, added inconvenience, or fear of hypoglycemia.
An in-office point-of-care HbA1c machine (see figure above, reproduced with permission from Alere Inc. © Alere Inc. 2017) allows you to get a finger-stick value in less than 6 minutes. This too can be completed by the medical assistant as the patient is checked in for their appointment. While this does require prescreening the chart to see who is in need of an HbA1c test, it allows for an immediate response that you control. All of which facilitates the real-time face-to-face conversation about the HbA1c and the finger-stick glucose readings from the patient’s glucose meter, giving you much richer data about the patient’s current glucose control.
In addition, you may even be able to earn a small profit from this practice. For example, in our clinic, we are able to bill for the point-of-care testing (as long as it has been 3 months since the last test) and earn a small margin from each test.