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Evidence to Improve Care

Point-of-Care Hemoglobin A1c Testing


Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee affirms the accuracy of point-of-care testing of hemoglobin A1c levels.

  • However, recognizing that the need for quality-controlled, readily shared, non-duplicated information on hemoglobin A1c levels is the real issue regarding access to the test, the Ontario Health Technology Advisory Committee recommends continuing laboratory-based testing. Furthermore, the Ontario Health Technology Advisory Committee urges that the Ontario Laboratory Information System reach full implementation as soon as possible to allow for sharing of hemoglobin A1c and other laboratory information between various health care providers involved in patient care.

Read the full OHTAC Recommendation report



Hemoglobin A1c is a blood test that measures the average blood sugar level over the past three months. Patients with diabetes should have hemoglobin A1c levels tested every three to six months. In Ontario, most patients with diabetes go to community laboratories or hospitals for hemoglobin A1c testing before their doctor appointments.


Health Quality Ontario Reviews Point-of-Care Hemoglobin A1c Tests

Point-of-care hemoglobin A1c testing is done at or near the site where the patient receives care and is an alternative to testing in a laboratory.

Point-of-care testing has several potential advantages: it is close to where the patient receives care; results are available fast, and testing patients in rural or remote communities is easy. Point-of-care hemoglobin A1c tests could be more efficient if its results are as reliable as laboratory test results.


Point-of-Care Hemoglobin A1c Testing: An Evidence-Based Analysis
July 2014 (PDF)


Point-of-Care Hemoglobin A1c Testing in Diabetes: A Budget Impact Analysis
July 2014 (PDF)


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The Ministry of Health and Long-Term Care has accepted these recommendations.

The Ministry of Health and Long-Term Care has provided the following response: The Ontario Laboratory Information System (OLIS) is operational and as of November 2016, OLIS collects 88% of all lab results generated by hospital, public health and community laboratories. Nearly 100,000 clinical users have access to OLIS data to support patient care.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.



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