POINT-OF-CARE TESTING
will usually take the form of the financial framework which offers guidance on how to review the budget data, analyse the cause of variation, and take action to understand the factors driving that variation.
Besides the monthly budget review,
there must be a calendar of quarterly business reviews of the service, and with suppliers, to review service performance, test use, clinical outcomes and vendor performance. This allows for regular adjustments to be made to ensure good control of spend or an understanding of cost pressures that are becoming unavoidable. This may be driven by organisational decisions on care pathways, short term initiatives to free up capacity in hospitals, or the increase of POC use outside of the hospital setting such as urgent treatment and diagnostics treatment centres.
The bottom line is that a business unit must demonstrate value on investment, be capable of delivering positive change through astute use of funds and to grow the service effectively through service delivery and recruitment strategies.
Business intelligence Key performance indicators (KPIs) must be defined to show the service is delivering on its objectives, and clear business reports should be available to executives and financial officers to ensure an appropriate level of autonomy continues. Other measures that must be considered include restricting the use of specialist POCT to defined clinical staff or teams. This includes stewardship of devices and tests located in protected units for specific uses as defined by patient symptoms or referral pathways. Specific panels of tests can be developed for patients presenting with certain suspected conditions, or as defined in national or local guidelines for testing. What must not happen is that expensive tests designated for use in specific cases are accessed by the wider clinical specialties. POCT middleware can be used to monitor activity and to generate KPI- related reports. They will not provide much in the way of financial analysis and POCT teams should consider investing in a business intelligence solution which can be used to analyse the cost effectiveness of the service, breaking down the cost per analysis and the overall value delivered in patient care. Improvements to POC data managers and middleware is being made, and business analytics must be a feature in any new solution under development. This is an area where potential AI-driven solutions can identify ineffective use of products, and improve commercial
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Horizon scanning is already uncovering the reality of patient-centred care with the growth in diagnostic hubs and virtual wards.
savings linked with improved efficiency of services.
This is where audit is also effective
in controlling use, with clinical audits performed by those teams using the tests to show the efficacy of the solution in that setting, or by a third party or someone neutral. Measures can be taken to prevent inappropriate access to these tests and allow cross charge for any inappropriate use discovered.
Service leads must consider partnerships with commercial healthcare companies who can offer the business acumen that may propel the service to become a business unit. This does come with many considerations around exclusivity, restriction of choice and ultimately the function of the service if not all elements can be delivered by one vendor through a managed equipment service agreement. Services must retain the ability to enter tenders and mini competitions at will, so that innovative diagnostic developments can be adopted at pace if so required.
Conclusions All POCT services, regardless of size and complexity, should be operating as a business unit with clear financial goals and accountability. A suitable structure should be implemented that allows for a degree of autonomy backed up by reporting mechanisms and a deep understanding of the organisation’s financial framework. Those appointed as responsible officers should have the experience and qualifications to deliver the role, and develop close relationships with
procurement, finance, recruitment and suppliers for the business unit to mature. Medium- to long-term vision and strategy is the key to success, re-evaluating risks and challenges on a regular basis so that the focus can shift to meet the clinical demand. If a new priority emerges, a current priority must be deprioritised through agreement. The route to accessing funding must be clear and attainable, with business plans and resource requirements continuously updated based on the shifting healthcare landscape. The main thing is to avoid overcommitting to new projects when resources and funding are not guaranteed, not applied for or clearly at risk of not materialising. Ultimately, the focus must be on value-based care to ensure funding is effectively used to deliver positive patient outcomes.
Tony Cambridge is the Managing Director of Thornhill Healthcare Events and Consultancy, and former Lead
Biomedical Scientist in the Pathology Management team of a busy acute care hospital in England. He frequently speaks at national and international healthcare events and is a key opinion leader for point-of-care testing. He is also a member of multiple scientific advisory committees and panels. Tony is the creator and owner of the POCT Innovators website and is fully active in promoting best practice and the wider point-of-care community.
www.poctinnovators.com SEPTEMBER 2025
WWW.PATHOLOGYINPRACTICE.COM
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