Abstract

Clinical User Requirements For Point Of Care Testing Technology

Paul Collinson, Consultant Chemical Pathologist, St Georges University Hospitals NHS Foundation Trust

Point of care testing already forms part of the routine landscape of clinical care. In developing novel point of care testing (POCT) platforms and improving on existing systems a number of criteria must be met for effective clinical use in both the inpatient and outpatient healthcare setting. Analytical performance of POCT must be appropriate, comparable with laboratory-based instruments but also compatible with the biological variation of the analyte in question. For some instruments analytical goals are relatively straightforward but for others more demanding standards will exist. Ease-of-use of instrumentation is to be expected in the current era of sophisticated consumer electronics but should also incorporate simplicity in quality assurance capability. The test panels on offer should reflect clinical patient flow to provide a coherent service. This may be technically challenging where the panel of analytes to be measured involve a range of detection technologies. Connectivity with seamless transfer to an electronic patient record is essential. Finally, provision of a rapid test result at the point of delivery of care is of little value unless it results in a prompt a change of management and an improvement in overall clinical cost. This cost effectiveness may be obvious, such as prompt hospital discharge where the cost of the test is outweighed by the patient episode cost. Cost effectiveness may be more subtle in the outpatient environment affecting either patient convenience or reduction in long-term morbidity. However, cost effectiveness will inevitably require examination of process and appropriate integration of POCT process improvement.