When convenience collides with demand

POCT products and services provide a wealth of value to both the clinicians who administer them and the patients who undergo them, according to Jamie Phillips, Ph.D., Senior Scientific Affairs Manager, Medical and Scientific Affairs, Roche Diagnostics Corp.

“Benefits and features can be markedly different when referring to point-of-care testing,” Phillips told Healthcare Purchasing News. “The unique value of a point-of-care test is its ability to provide a critical result faster, near the patient, allowing healthcare providers to determine the best course of action or treatment quickly. This provides obvious benefits across a variety of settings, from the emergency room to a community pharmacy and even at-home care or self-testing.”

Phillips references numerous peer-reviewed studies that have shown that testing for respiratory infections at the point of care can:

• Shorten a patient’s length of stay in a hospital setting
• Enable appropriate and timely treatment
• Reduce unnecessary testing
• Help healthcare providers implement appropriate patient isolation when needed

“Additionally, many point-of-care tests are classified as CLIA-waived,” she continued. “Tests that are considered CLIA-waived use direct, unprocessed specimens, and are easy to perform with negligible chance of error. Thus, they can be performed by individuals without formal laboratory training. This facilitates their use outside of the central laboratory setting, offering healthcare institutions greater flexibility and streamlined workflows.”

Clinicians and healthcare organizations favor POCT’s convenience.

“For clinicians and healthcare institutions, the greatest benefit of point-of-care testing is that it enables them to access patient test results faster and more conveniently,” Phillips noted. “This helps them identify the best course of action or treatment quickly, often while the patient is still in their care. Improving their ability to prescribe the appropriate medication contributes to greater antibiotic stewardship as well.”

They also favor another “C,” according to Joseph Vickers, Product Manager, Membrane & Media, Pall Medical.

“From our interactions, the factor which is always highlighted as the most important is test consistency,” Vickers said. “This is influenced by many aspects of the overall quality of the test materials, including sample capture substrates, reaction pads and visual indicators. The clinician must not experience any ambiguity or subjectivity in the test results. They must get the right result every time.”

For patients, POCT affects their experience, which then motivates satisfaction survey results used to determine reimbursement.

“Point-of-care testing can improve the patient experience significantly,” Phillips observed. “The patient can often find out the results of a test during the same physician visit rather than returning home or waiting in a hospital bed and worrying about what the results might be. As a result, the process can be much more convenient for the patient and can provide greater peace of mind.”

Unfortunately, not all POC tests generate fast readouts or results, regardless of proximity to patient or facility location.

“Many of the point-of-care tests from Roche provide results in about 20 minutes or less, which would be considered rapid,” Phillips noted. “Some point-of-care tests may use a chemistry that requires a longer reaction and analysis time. However, there is still an advantage to having the testing close to the patient because it helps to mitigate the workflow, safety and time challenges that can occur when sending a patient sample to a central lab location. Another significant advantage to point-of-care testing unrelated to test turnaround time is that it provides access to testing for remote populations that cannot easily come to a central healthcare facility or testing location.”

For Pall, patients prefer a fundamental requirement.

“Top of the list for the patient is accuracy,” Vickers insisted. “Undergoing medical diagnostics is often a stressful process and the results of a POCT must be accurate. The impact of false positives or negatives on a patient’s treatment process and overall health and well-being can be catastrophic. False results must be avoided at all costs.”

Connectivity concerns

One way to improve point-of-care testing prospects involves electronic accessibility, according to Phillips.

“Many point-of-care tests are not connected electronically, or through a cloud-based data management hub, so providers are required to enter testing results manually into the patient’s EMR, or electronic medical record,” she indicated. “There is a significant opportunity here to use connectivity to eliminate many manual reporting elements. Having seamless connectivity between point-of-care testing and the EMR system would create greater efficiencies and improve documentation of testing, with less risk of error or omission during transcription.”

Of course, data privacy and cybersecurity issues loom large as a challenge.

“Certainly data privacy and security are important considerations in any connectivity solution,” Phillips acknowledged. “But device manufacturers and healthcare institutions can partner with cloud-based data security providers to address those concerns effectively.”

In fact, there’s a high probability that POCT becomes standard operating procedure during the next decade, accelerated perhaps by current pandemic events.

“Seamlessly connected POC testing is very likely to be the norm rather than the exception a decade from now,” Phillips forecast.

Ease of use and overall utility top Pall’s list of desired improvements, Vickers indicates.

“One of the main advantages of POCT is the ability for the test to be performed by a minimally trained individual, often in an adverse environment,” he said. “A large positive impact to POCT could be made by improving the tests’ ease of use – both during operation of the test, in terms of its robustness and simplicity to use, and combining that with the effortless interpretation of results.”

Digital upside

Phillips predicts a bright future for POCT products and services by 2030, taking cues from convenience concepts and experience ideals in other industries.

“The healthcare landscape is evolving rapidly today, and one of the primary drivers of the evolution is digital technology,” she observed. “Healthcare is starting to catch up to industries like transportation and retail shopping, where innovators like Uber and Amazon have transformed the business models and the consumer experience. The introduction of wearable technology and mobile apps is already changing the way consumers engage in their own healthcare.

“A decade from now – or sooner – one could envision how secure wireless connectivity and personal healthcare apps could further change the way vital health information is accessed and shared between patient mobile devices, databases such as electronic medical records, and point-of-care testing devices, including those used at home for patient self-testing,” she continued. “While there are hurdles to overcome, this enhanced, real-time connectivity could provide a more efficient, seamless and convenient experience for both patients and providers, helping to improve patient care while reducing costs.”

Vickers foresees expansion and complexity defining POCT products and services during the next decade.

“As we move to a more cloud-based and connected society there will be big changes in POCT over the next 10 years, and we have to think about integration of testing and apps,” he noted. “As POCT develops and we see more multiplex and qualitative testing, app integration could provide many advantages, such as the ability to have qualifying questions about symptoms and recent experiences prior to taking the test.” Further, this might enable the caregivers to provide more qualitative interpretations and feedback with more context to the patient, he added.

Vickers also contemplates a migration to “more advanced whole, cell-based diagnostic markers, moving away from the protein- or hormone-based markers often used today and enabling the provision of more sophisticated insight into the disease state.”