EPOC Conversion

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Would like to get feedback from those of you who converted from i-STAT to EPOC? How was your experience? What are the pros and cons? Thanks.

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EPOC Pros:
  • cartridges do not need to be refrigerated and will not expire until the manufacturer expiration date unlike iSTAT.  This is huge, no more dating cartridges when they come out of the fridge.
  • ability to easily pick specific tests on a cartridge to be performed unlike iSTAT.  This was huge for our Dr's.
    • only one cartridge type for all tests it does, this means less QC to be performed, less LOTs to deal with.
  • I'm not aware of Epoc cartridges losing FDA approval unlike iSTAT has done multiple times.
  • updated user interface, touch screen
  • sample is inoculated into the cartridge in a manner that significantly reduces its exposure to air: more accurate patient ABG results.  Epoc is less technique driven in obtaining good sample results for this reason.  I've seen staff simply not able to master the technique required and therefore not granted access to use it.
    • iSTAT cartridges inoculation method exposes all samples to air which changes its results.  Bad technique = bad results.

Epoc Cons:
  • doesn't do Troponin, ACT, bHCG or PT like iSTAT does.

Converting to Epoc from iSTAT: stress to users that the cartridge must not be inoculated until it has been inserted into the "Reader" and the 180 calibration timer has finished.

Epoc rate of "Breakage" on instruments that must be replaced due to malfunction seems to be very similar to iSTAT.

Experience: Switched from iSTAT to Epoc about 16 months ago.  ~800 users and 70 analyzers.

Welcome

I really like the EPOC. I like the all in one card and the fact you can select the individual tests you want. I think it's easier and uses less QC and Linearity for validations and monthly QC because of the all in one card vs the multiple istat cartridges. The EPOC cards can stay at Room Temp. The QC and linearity are refrigerated. I don't remember all the QC involved for the istat. There are 4 levels of QC that need to be run monthly with EPOC. Normal & Abnormal BG, Electrolytes and Metabolites and Normal & Abnormal HCT. 

The staff didn't like it so much. Their major complaint was, "It takes too long." It takes the same amout of time as the iStat. It's just the calibration is performed on the front end before you add the sample vs with iStat, you submit the sample and wait 2 minutes for the result. 
iStat - insert sample into cartridge--> insert cartridge into istat --> wait 2 minutes for results
EPOC - Insert Card --> wait for 2 minute calibration --> insert sample --> results in 30 seconds.
IStat and EPOC were create by the same person. 
The staff is incredibly inpatient for the 2 minute calibration on the front end to present the sample vs immediately producing the sample and waiting for the 2 minutes for results. 

EPOC limitations - no ACT or coag results. EPOC is 2 pieces. Reader and Host. Cath Lab would sometimes remove the host from the reader and put them back on the wrong reader and then call me because, "it's broken." The Host and Readers are not interchangeable. 

EPOC Technique - The way to present the sample is not as easy as istat but gets easier with practice. IStat has the capillary action to collect the specimen in the cartridge vs EPOC where you take the plunger of the syringe, insert it into the collection area, turn the plunger a quarter turn, then press down on the plunger a smidge to add the sample. It beeps when you have enough sample. Users tend to overfill the card or have bubbles. Most people adjust and get used to it. They all still complain about the time it takes to present the sample.  

Uploading the new software is easier with IStat, in my opinion but the EPOC is not so bad. I didn't like that I didn't get EPOC reminders to upload software like abbott sends. 

Overall, I like EPOC. It just takes some time to get used to since it is different. Hope this is enough info for you,  

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