MLTs contribute to your care by doing everything from collecting specimens, to carrying out and monitoring procedures, to interpreting findings.
In Ontario, your lab test can be ordered by several types of health care professionals. In this section, find the answers to common questions about lab tests (Who takes your blood samples? How to get a copy of your results?) and links to other resources and learn more about the role of these health care professionals.
The health professionals authorized to order medical laboratory tests are defined by Ontario Regulation 45/22, the Laboratory and Specimen Collection Centre Licensing Act, R.S.O. 1990, c. L.1, under section 18:
Laboratory tests
- (1) The owner and the operator of a laboratory shall ensure that no person employed in the laboratory performs a test unless a requisition for the test is made by,
(a) a member of the College of Physicians and Surgeons of Ontario;
(b) a member of the Royal College of Dental Surgeons of Ontario;
(c) a member of the College of Midwives of Ontario, but only in respect of a test specified in Schedule 2;
(d) an aboriginal midwife, but only in respect of a test specified in Schedule 2;
(e) a member of the College of Nurses of Ontario who holds an extended certificate of registration under the Nursing Act, 1991;
(f) a member of the College of Naturopaths of Ontario, but only in respect of a test specified in Schedule 1;
(g) a member of the Ontario College of Pharmacists who is registered as a pharmacist under the Pharmacy Act, 1991, but only in respect of a test for COVID-19;
(h) a member of a health profession in a jurisdiction outside Ontario, if a person employed in a laboratory in that jurisdiction is permitted by law to perform a test in respect of a requisition made by the member;
(i) an insurer or agent within the meaning of the Insurance Act; or
(j) an individual who is authorized by Telehealth Ontario to make a requisition in respect of a test that is funded under the provincial colorectal cancer screening program.
(2) For the purpose of assisting a person employed in the laboratory to perform tests, the operator of the laboratory may collect personal health information about an individual indirectly from the person referred to in clause (1) (d), (h) or (i) who makes the requisition for a test.
POINT-OF-CARE TESTING IN ONTARIO
The CMLTO and O. Reg. 45/22: GENERAL under the Laboratory and Specimen Collection Centre Licensing Act, R.S.O. 1990, c. L.1 defines point-of-care testing (POCT) as test that employs a medical device authorized by the Minister of Health (Canada) for point-of-care use. POCT may or may not be performed by laboratory personnel and the results of the testing are used for clinical decision making.
The quantitative impact that POCT is currently having on the professional practice of bench-level MLTs in hospital laboratories was assessed through a survey of Practising MLTs. The data demonstrated that:
- 83% of survey respondents identified the Laboratory as being responsible for POCT.
- The most common POCT tasks focused on quality control including testing and equipment control.
- 55% of survey respondents identified POCT as having an impact on their daily professional practice. However, within that 55%, the majority identified the impact as minimal.
Interprofessional collaboration (IPC) can be a key enabler to POCT, especially when the testing is being performed by other health professionals (i.e., nurses), and supported by the laboratory and MLTs.
Through its mandatory Quality Management program for licensed laboratories, Accreditation Canada programs for laboratory accreditation and proficiency testing ensures these facilities are responsible for the quality of the laboratory results generated to support patient care. The IQMH requirements are based upon and referenced to International Organization for Standardization (ISO) requirements for laboratory quality in general, and POCT specifically. Please note that Re. 45/22 under the Laboratory and Specimen Collection Centre Licensing Act, R.S.O. 1990, c. L.1 contains exemptions from licensing related to Point of Care Testing.
