January 29, 2019Christoph Pedain, PhD
In today’s healthcare system, the need for quick and accurate medical decision-making calls for the right type of test result to be available at the right time. Given the cost challenges and labor shortages many clinical laboratories face, healthcare providers must find new ways to deliver in-vitro diagnostic test results efficiently.
Enter point-of-care testing (POCT). Several large US hospitals have successfully introduced POCT instruments in their sepsis programs. Huntsville Hospital in Alabama is a prime example. Having converted blood gas testing throughout the hospital from benchtop to handheld analyzers a few years back, the hospital began exploring additional areas in which to use handheld devices. One area they had targeted for improvement was sepsis care. For every hour sepsis patients spend waiting for an antibiotic, mortality increases. By implementing handheld blood gas analyzers, clinicians can now check a patient’s lactate level in three minutes to help initiate treatment sooner and reduce a patient’s risk of complications. The greatest benefit in this hospital was improving the quality of care: The hospital reported that mortality rates dropped by nearly 50 percent in the first six months of implementation. From a financial standpoint, the introduction of POCT also made business sense: savings in workforce efficiency and improved patient flow far outweighed the necessary investments.
Since its inception more than 6,000 years ago with the introduction of “urinalysis,” as later conceived by Hippocrates, POCT has evolved to include blood gas testing, cardiology, sepsis care, and much more. In addition, parameters for testing have progressed, education for IVD testing has become more specialized, and many qualitative observations have been developed into complex quantitative algorithms.
With POCT, critical tests can be processed quicker, facilitating patient care for emergency situations such as suspected venous thromboembolism or sepsis. Maintaining specimen integrity is another benefit: instruments are located nearby, and testing is immediate, which reduces the likelihood of processing delays that could impair sample viability. Also, as health systems are increasingly focused on value-based patient care, POCT can supplement missed or underutilized testing and improve the patient experience by reducing wait times and travel needs.
While the benefits of POCT are clear, some clinicians may be reluctant to introduce new instruments for fear of overloading an already lean workforce with a new technology to learn. To address this challenge, some manufacturers have incorporated safety and quality control measures into the instruments and their corresponding software, such as “intelligent” urine strips that automate quality checks by detecting humidity exposure and automatically identifying the strip type. These features enhance testing accuracy and workforce productivity by automating certain processes, eliminating the subjectivity of visually read tests, and reducing transcription errors.
With a greater number of patients to manage, more stringent regulations to follow, and evolving technologies, clinicians have a full workload. Finding the right balance of POCT combined with laboratory testing is worth the investment in process and equipment innovation. Companies that supply both laboratory and POCT solutions are in a position to offer standardization and correlation across testing sites and along a patient's journey. Using the same technology across multiple settings maximizes efficiency for the clinician, and can therefore expedite and improve diagnosis and treatment for the patient.