SPECIAL FOCUS
Whereas with POCT the test is generally run immediately and preanalytical dif- ferences between tests are minimized.” Begos emphasizes that while speed may be one important advantage, it’s “always secondary” to an accurate result. “Fortunately, most POCT devices are now as accurate as the central laboratory analyzers, and the results can be trusted and acted upon,” he added. “In fact, in one recent study, a handheld POCT device was more accurate than a hospital central laboratory in eGFR testing.” Jon Gingrich, CEO, Echosens, con- centrates on the nuances of patient centricity and active participa- tion in their healthcare processes as important differentiators. “POCT
to o l s c an
enhance the patient expe- rience and outcomes through patient- centric care and help providers achieve the Triple Aim [of] convenient, affordable and accessible care,” Gingrich noted. “FibroScan, for example, is a liver stiffness assessment tool that can also measure how much fat is stored within the liver, at the point of care, that provides rapid results for timely, earlier interventions that help keep patients on track with lifestyle changes. These useful tests allow more clinicians to access the technology and treat more patients typically earlier in the management pathway, which reduces total overall healthcare costs.” Recognizing that patient experience and
Jon Gingrich
satisfaction can affect reimbursement, ingrich emphasizes clear fiscal benefits. “POCT tools can also help health sys- tems and hospitals positively impact STAR ratings and give them a stronger competitive position,” he said. “In gen- eral, POCT is about better serving the patients, advancing care compliance and expanding provider capabilities around disease management and chronic care management.”
Dena Marrinucci, Ph.D., Co-Founder
and Chief Operating Officer, Truvian, POCT benefits center on three primary attributes: Accuracy, convenience and affordability.
“The COVID-19 pan-
demic placed a bright spotlight on challenges
Dena Marrinucci
that have existed for many years in diag- nostics, exposing the need for accurate and rapid testing that is accessible and afford- able to all,” she said. “The new generation of point-of-care testing delivers on three
key dimensions: accuracy, convenience and affordability.”
Marrinucci remains solidly behind
accuracy, convenience and affordability as effective ustifications for T. “Accuracy is a non-negotiable as quality cannot be compromised for any reason,” she insisted. “POCT that demonstrates comparable sensitivity and specificity levels with centralized lab machines will ensure consumers can focus on the treat- ment plan recommended by providers, instead of worrying about whether or not their results were reliable. “onvenience provides benefits for con- sumers and providers alike,” Marrinucci continued. “Rapid sample-to-results empowers consumers to get answers to their health questions before they leave the clinic or doctors office. For providers, the streamlined workflows and ease of use afforded by POCT expands the ability to meet consumers where they are in the context of their lives, fulfilling the promise of decentralized testing. “Affordability is top-of-mind for health- care consumers as deductibles and out- of-pocket expenses steadily increase year after year,” she observed. “POCT plays an important role in increasing access to essential healthcare services, reducing the financial burden that can often deter patients from getting the care they need.”
The questionable
As with any device or technology, the benefits also may be balanced with limi- tations or works in progress that POCT experts readily acknowledge as part of development and progress.
Nova Biomedical’s Begos asserts that
“accuracy is paramount – it trumps speed and convenience,” but some issues can complicate matters, particularly within glucose testing.
“Many POCT glucose monitoring devices have interferences from exog- enous substances (i.e., medications) or endogenous factors (i.e., anemia, acidosis), that make them error-prone in critically ill patients,” Begos said. “Not every device suffers from these limitations, and there is one POCT blood glucose monitoring system that has been approved by the FDA and Health Canada for use in criti- cally ill patients.”
Echosens’ Gingrich cautions about the economics of POCT in context of labora- tory capabilities and advises clinicians and administrators to take a holistic approach based on facility needs. “Providers should understand the importance of acquiring expensive test- ing and diagnostic capabilities before
investing,” he said. “For instance, assess- ment and analysis of test findings may require additional expertise — adding to the cost. With this in mind, understanding how the particular T will fit into the patient pathway, what information the POCT can and cannot deliver and what decisions the healthcare provider can and cannot effectively make will optimize its benefit.
“Other considerations include knowing up front if the technology is portable and how much space it requires, as well as who will be qualified to operate the equip- ment and interpret results,” Gingrich continued. “FibroScan is designed to be performed by a medical assistant in the physician’s office for the physician to interpret within minutes. Also, it’s cov- ered by Medicare, Medicaid and most insurance plans, which is important to patients.” Focus on the patient profile, according to Gingrich.
“Purchasing decision makers should also consider the overall cost of patient care, which may be lower when POCT is employed because it allows patients to be treated or processed more quickly through the healthcare system, as well as more effi- ciently rule-out those patients who do not need more expensive and advanced test- ing,” he said. “This is a significant benefit to POCTs. Other limitations may include appropriate documentation, which could be challenging due to testing and person- nel location, administrative oversight of personnel and storage of records. Also, some POCT equipment may not be inter- faceable or may require storage.” Truvian’s Marrinucci remains sacro- sanct: “It’s important to evaluate options comprehensively for the intended use case, as some POCT devices may be less accurate, specific andor sensitive than the testing performed in a clinical labora- tory setting,” she urged.
The curiously intriguing side from the benefits and limitations of POCT, all three POCT experts marvel at the ongoing developments and prospec- tive capabilities that POCT promises to offer in the future.
Begos homes in on outside the hospital setting.
“One of the areas where POCT will be paradigm-changing is outside of the hospital,” he predicted. “POCT creati- nine and eGFR is already being used in remote areas and in low- and middle- income countries where access to health care is limited. In these environments, acute kidney injury (AKI) and chronic
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