The Incredibly Talented i-STAT

Exact numbers are not available, but I would venture to say that more than half the hospitals in the U.S. have i-STATs, and almost every ambulatory surgery center, surgical hospital, and stand-alone emergency room in the U.S. has one or more. Many healthcare entities have numerous i-STATs. As Saran Wrap became the name for plastic wrap, Abbott Laboratories’ i-STAT is poised to become the name for point-of-care laboratory testing.

Besides its use as a glucometer, the i-STAT is best known as the instrument that created laboratory-like point-of-care testing. The i-STAT first surfaced in hospitals as far back as the early 1990s. Primarily targeted to emergency room settings and critical care areas, the i-STAT took off as a point-of-care instrument. At the time, skepticism was high. But by the turn of the century, the i-STAT had become distinctly entrenched as a point-of-care testing system in hospitals and other settings. The relevance of i-STAT results has weathered the test of time.

The i-STAT today. Results can be downloaded to middleware non-wirelessly or wirelessly.

Versatility is the key

The i-STAT is incredibly talented because—unlike larger traditional laboratory instrumentation—it can perform chemistry, hematology, coagulation, cardiac markers, and various other tests on one platform. Many tests can produce results in less than 10 minutes. No other system has the breadth of different technologies and the speed of testing on one platform.

What really sets the i-STAT apart from other lab instrumentation is that the i-STAT is not really a laboratory analyzer; it simply reads and collects the data. Each individual cartridge that is placed into the i-STAT is the real analyzer. Each time you perform an i-STAT test, you discard the analyzer and get a new analyzer (or cartridge). It’s an anomaly in the laboratory: the test cartridge is the analyzer, not the machine.

Low in cost and easy to use

It’s not just its flexibility and breadth of testing that have made the i-STAT so valuable—it’s the low acquisition cost and ease of use. It is by far one of the easiest laboratory systems to use, and the cost of the i-STAT reader is very affordable. An i-STAT reader can range in price from about $13,000 to as low as about $6,000. Most users will pay somewhere between $7,000 and $9,000.

An i-STAT cartridge, which contains the actual analyzer, requires only a small amount of blood for testing.

But as with many other low-cost items, there are lots of accessories, and a few of them are almost mandatory. The cartridges that go into the i-STAT can be pricey ($5–$10 each), but keep in mind that the cartridge is the analyzer.  Accordingly, $5–$10 for an analyzer that you use once and discard is not really a bad price.

However, you can easily get into thousands of dollars in costs, and depending on the setting and the application you may not be able to charge directly for the testing. In summary, the capital cost for an i-STAT is low; it is the consumable cost can almost be outrageous. Clearly, ease of use and minimal testing time may justify the cartridge cost. To put this price into perspective, routine tests done in a laboratory on a floor analyzer cost pennies.

In addition, there have been concerns about the use of the electronic simulator, waived and non-waived, and calibration verification. So talk with a laboratory expert before buying an i-STAT.

Only one competitor

There are many competitors in the point-of-care testing setting, but there is nothing like the i-STAT. It is truly one-of-a-kind. The only real competitor is the epoc system by Siemens Healthineers. As it happens, the epoc is a different spin on the same technology as it was invented by the same person who invented the i-STAT. The epoc system does not have the same breadth of tests available and is not nearly as well known in the marketplace as the i-STAT. The epoc puts a very small dent into the point-of-care market that the i-STAT rules undeniably rules.

Abbott’s planned a redesign of the i-STAT reader includes a much larger screen and additional bells and whistles. The new system has not yet hit the market, and it remains to be seen whether it will be regarded as being as accomplished as its predecessor. Regardless, the current i-STAT is incredibly talented and one of the most successful laboratory platforms ever.

The future of the i-STAT includes a larger screen.

Dennis Matricardi, Clinical Analyst

Dennis Matricardi joined MD Buyline in 2000 with more than 30 years of hospital-based laboratory experience.

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