SPECIAL FOCUS The prospects, prominence,
possibilities of point-of-care testing Outcomes can span the promise, the questionable and the curiously intriguing by Rick Dana Barlow
Photo credit: Fabio Balbi |
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ne thing clinicians and patients alike consistently have demanded or sought during the COVID-19 pandemic – access to testing for the virus, along with convenience and speed of obtaining the results. Unfortunately, the desire for conve- nience and speed sometimes can affect the accuracy, integrity and security of results. While the healthcare industry may be closer to seeing the emergence of “tri- corder” technology used in the cinematic “Star Trek” franchise than ever before, it also recognizes that such science fiction technology is not ready for prime-time or even real-time applications … yet. Still, the desire for convenience and speed motivates the research and devel- opment for such advancements as techno- logical development pushes boundaries about which healthcare administrators and clinicians – as well as patients – only can dream of and conceive right now. Although today we reside in the “right now,” appreciative of the capabilities and contributions that current point-of-care testing products provide caregivers and patients alike look forward to what’s in store, but with caveats and within reason.
The promise
From measuring a variety of vital signs as well as V- and influenza among others, point-of-care testing (POCT) pro- vides a wealth of key benefits for clinicians and patients. Dennis Begos, M.D., Medical Director, Medical and Scientific Affairs, Nova Biomedical, points to what he calls the obvi- ous – speed of results. “With near real-time results, clinical and in the case of COVID testing, social and political decision-making, can also be expedited,” he told Healthcare Purchasing News. Begos refers to blood glucose testing
Dennis Begos
as an example of why speed matters. “Many critically ill patients are on tight glucose control parameters in the ICU,” he indicated. “Insulin drips are common, and blood glucose can change rapidly under these conditions. Sending blood to the central laboratory can often take over an hour to be resulted, causing delay in treatment and potential patient harm. In addition, the treatment is based on what the patient’s glucose was an hour ago,
10 September 2021 • HEALTHCARE PURCHASING NEWS •
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which may have rapidly changed in the ensuing hour. Lastly, a nurse caring for a patient sends down the specimen but by the time it comes back he or she will likely be doing something else and thus further delays ensue.” POCT glucose testing capabilities, how- ever, alleviate much of this.
“With POCT glucose testing, results are known within seconds, and the appro- priate clinical management can happen immediately,” Begos noted. “In addition to glucose, we can now measure ionized magnesium (iMg), ionized calcium (iCa), hemoglobin and hematocrit, lactate and many other parameters that have similar time-sensitive clinical implications.” POCT also provides consistency of results as another advantage, according to Begos.
“Many tests sent to the central labora- tory will change over time, such as lactate and glucose,” he said. “This leads to an inherent bias, especially when trending results, as is often done for both of those analytes. If one specimen sat for 45 min- utes, and another was run immediately, or if one was on ice and one wasn’t, the preanalytical factors can be significant.
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