Physician office CBC - Peds

We have had the Sysmex pocHi 3 part diff analyzer in our Whistler Health Care clinic Emerg dept for many years. It is currently not interfaced. The RN leaves the printout for patient & QC affixed to a POC result form and the lab enters into LIS the next day, which then populates the EMR. 
Would love to have the device interfaced either to LIS or POC middleware (really a must, but in queue for $). Lab runs daily commercial QC, RN runs a lab-provided Normal blood each time a patient is run. The pocHi has been reliable. There is a swap in / out process for repair.
Personally, a 6 part diff small analyzer like the Sysmex XNL-430 would be my choice if it could be deemed POC. Diff sensitivity then is improved, the RN could run the commercial QC easier, and it's also cap-piercing. Would also have it interfaced. 

We have the waived Sysmex XW-100. Nurses and Medical Assistants use it. Can't run patients under 2 yrs old, and it cannot be interfaced, if that is something you are looking for. Otherwise it is a pretty fool proof analyzer and walks the operator thru everything on the onboard screen.

We use the pocHi as well in 2 of our clinics. We have a full time senior lab assistant at each location that performs the majority of the testing. The LPN/RN nurses, however, are trained as well to assist when needed. This being a moderately complex test- I have to complete the competencies with them on the required basis and there are about 16 of them. Our patient population is 0-80+. We are not interfaced, however it would be much easier if we were. ($) :( The pocHi itself is ok. I do feel that we have to have it serviced nearly once a year it seems. (Where we send it in.) However, I have not worked with any other bench top CBC analyzers so I have nothing to compare it to. 

I have a Primary Care Clinic with a walk-in clinic that uses Horiba Micros ABX 60 with Lite DM (chosen before I started).  It is a 3-part differential.  Nursing staff are the ones running the instrument, at this particular clinic they do have a Lab Nurse that has taken it as her "baby" and is their go to person.  Pro -- it does throw different types of flags on the Lite DM software as well as printouts if there is an issue (ie WBC flags and Platelet Flags).  Cons - Troubleshooting can take a little while, especially since nursing staff's education is not the same as MLS/MLT; MPV ranges have been a pain for me since I started, our patients are consistently low compared to ranges from our main lab in our Health system that uses Sysmex (there comparisons do show below a 10% bias) and even using the ranges from the small study in the operator's manual.  Patients are calling when they use google to determine what it means if the MPV is low, even though the rest of their labs are normal.  When we do quality control or proficiency testing the MPV values are fine, just need to find the correct range for patients and it hasn't been easy to find.

I also have 2 other clinics set up for the instrument, but do not currently use it.  It is interfaceable, which we currently have set up for CBC and Diff  through DI for our Health system.

We are looking to use Sysmex XN450 in other clinics as we get those set up in the next few years.  I had 2 charge nurses look at the XN550 and they liked it as it helped with troubleshooting and maintenance was a bit easier.