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TRIAGE TESTING


clinical knowledge and experience can override where necessary. No test is 100% accurate or precise. It should not be anticipated or expected. Diagnostics companies work tirelessly to remove the element of doubt, but there is no substitute for clinical presentation and patient history. Test results together with the clinical interpretation will yield the most effective care. The most effective care for any individual would be based on their history, presentation and analytics. Precision care and personalised care can only be achieved when reliable solutions are accessed rapidly by the clinical teams providing care. If there is a narrow spectrum of diagnostics available to the clinician, then patient care slips back into generalised medicine where a battery of tests is ordered on a ‘just in case’ basis. This is not good for the clinician or the patient. It is also a real problem for health economics, patient flow, and limited resources.


Accessibility of diagnostics tests Where should these diagnostics solutions be offered? There is a growing body of evidence to suggest that performing more tests outside the traditional medical laboratory can yield improved results. The problem remains that the infrastructure cannot currently support this approach, and models of test provision in multiple settings must be devised, for example: n GPs and Health Centres n Primary Care Network Hubs n Minor Injury Units n Local Care Centres n Urgent Care Centres n Ambulatory Units n Community Clinics (sexual health/family planning)


n Pharmacies n High street wellness centres n Community Team home visits n Paramedics n Ambulance Service (including air) n Mobile Units (see list below) n Prisons n Gyms and Health Centres.


Areas where large numbers of people would normally gather or visit are also prime locations for diagnostics and require mobile solutions, such as: n supermarkets n sporting events n care homes n concerts n festivals n other large gatherings.


It is clear that what is needed is a national network of community diagnostics with


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Patient with acute respiratory infection (eg fever, couch, shortness of breath)


FebriDx Rapid Triage Test 10 min


Viral infection


Bacterial infection


Non-systemic infection


Cohort viral patients to prevent spread of infection and manage appropriately


Cohort away from patients with viral infections


FebriDx as a rapid triage tool that detects both influenza and SARS-CoV-2 is likely to be of utility in the coming winter months.


all results generated available through a complete and accessible patient health record. This requires significant vision and appropriate levels of investment shared between government organisations. Patients presenting with early symptoms of common conditions should be managed away from acute services. Likewise, those presenting with acute symptoms must be able to access diagnostics regardless of the day of the week, or the time of day. Provision of care must not be a lottery; instead it should be standardised to the level that the same care is received when it is required, not based on where or from whom it is received.


The banner of community diagnostics covers a multitude of settings and demands an overhaul to the system. From environmental to technical to staffing issues, the redesign of services required is wholesale and could be too much of a challenge for some. However, if patients and clinicians are to benefit from the health system they deserve, the blueprint needs to be designed and implemented now in order to reach the outcome; a more effective, efficient and financially viable service. One that all involved in can be proud.


Future relationships


The system to which we have become accustomed is not the system that patients require for the future. Identifying common illnesses early is key to reducing the burden on acute and secondary


services. Managing known conditions more effectively will improve measurable outcomes and thus prove the model. Cost avoidance and financial savings will rapidly become apparent, leading to further investment of time and effort in rolling out nationwide and global initiatives.


Now is the time for bravery; for leaders


in all areas of the healthcare landscape to embrace the solutions clearly available, and engage with global, national and grass-roots diagnostics companies in delivering patient services of the future. Setting firm foundations now is essential for future successes and galvanises the partnerships required to safeguard the longevity of the diagnostics industry and the effectiveness of patient care.


Tony Cambridge is Managing Director of Thornhill Healthcare Events and Consultancy, and Lead Biomedical Scientist in the pathology management team of a busy acute care hospital in England. He recently co-wrote the British Society of Haematology’s point-of-care testing guideline for general haematology and remains active across healthcare platforms offering advice and guidance.


Further information is available for Una Health.


Email: enquiries@unahealth.co.uk Web: www.unahealth.co.uk


Clinical evidence relating to FebriDx can be found online (www.febridx.com/covid- 19-triaging#clinical-evidence).


DECEMBER 2020 WWW.PATHOLOGYINPRACTICE.COM


PPi


PATHOLOGY IN PRACTICE


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