Analyzing quality control specimens is a daily component of modern medical laboratories to help assure that correct results are reported for patient samples. That involves periodic analysis of materials with a known analyte concentration and estimating if measurement error is within acceptable criteria. The QC samples may be obtained commercially or prepared within the laboratory. However, how adequately do those samples represent authentic patient samples? What if we were to use the patient samples themselves as a source of quality control data? That’s not as radical as one might think as implementation and application of moving averages of patient results was suggested as early as the 1960s, but the practice never really caught on. A Review paper appearing in the August 2019 issue of Clinical Chemistry re-examines this concept and perhaps newer software can provide such data in near real-time, or as the paper calls it, patient-based real-time quality control.