automated laboratory testing include:
• The push for patient centered care
(rise of personalized medicine)
• Chronic laboratory staff shortages
• Rapidly increasing older population,
leading to increased incidence of
chronic diseases
• Rising incidence of lifestyle diseases
(e.g. cardiac, diabetes)
• Increased demand for home-based
POC usage (facilitated by
technological innovations)
• Increasing trend toward healthcare
decentralization (linked to rise of
mobile technology)
• Long-term savings/cost benefit analyses
(preventive vs. curative medicine)
• Rural locations with limited
laboratory services (linked to
laboratory staff shortages).
POC Testing:
What, Where and Who?
In light of the many factors leading to the
increased demand for POCT,
manufacturing companies are pushing the
envelope to make POCT devices faster,
easier, and more reliable. The global POC
diagnostics market is forecasted to grow at
a compound annual growth rate (CAGR)
of 9.3% from 2013 to 2018, and to reach
$27.5 billion by the end of 2018.
Hundreds of tests once considered
too complex for POC are now routinely
performed outside the laboratory.
Sensor technologies enable the rapid
analysis of blood samples for many
critical care assays, including:
Blood gases/electrolytes
Cardiac markers
Cholesterol/lipids
Coagulation monitoring (INR; ACT,
Heparin; Hemostasis Assessment)
• Drugs of abuse testing (DAT)
• Fecal occult blood
• Food pathogens
• Glucose monitoring; Hemoglobin
A1C
• Hematology
• Infectious diseases (such as Influenza
and Rapid Strep)
• Pregnancy and fertility
• Tumor/cancer markers
• Urinalysis testing
• Other Chemistries (Magnesium,
Lactate, Micro-albumin, Creatinine)
• D-dimer for thromboembolism
Future: Tests Trending
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“ In light of the many
factors leading to the
increased demand for
POCT, manufacturing
companies are
pushing the envelope
to make POCT devices
faster, easier, and
more reliable.”
Irwin Z. Rothenberg, COLA Resources, Inc.
rapid diagnosis in the physician's office,
ambulance, home, the field, or in the
hospital room. Clinicians become
empowered to make decisions at the point-
of-care and this can have significant positive
•
impact on healthcare delivery and address
•
some of the challenges of health disparities.
•
There are other potential benefits
•
depending on the specific situation and
•
testing:
•
• Less sample volume (pediatric,
•
neonatal, ICU venues)
• Decrea sed pre-analytic concerns
POCT is performed in many non-
related to processing of specimens (i.e.
laboratory sites such as urgent care
clotting, centrifugation, preservation)
centers, outpatient clinics, physician
• Optimized drug treatments
office laboratories, retail clinics (such as
• Reduced post-op care time
CVS and Walgreen Pharmacy Minute
• Reduced hospital admissions
Clinics), ERs, nursing homes, ambulatory • Reduced hospital stays
coagulation clinics, the patient bedside,
and in patient homes. Each of these
Challenges of POCT
environments has different testing needs, Although POCT provides rapid results
variability in staff available for testing,
and the opportunity for faster medical
different data processing procedures, and decisions, the risk of errors with POCT
different regulatory requirements.
often raises concern over the reliability of
Point of Care Testing may be performed test results. In contrast to the core lab,
by nurses, MAs, EMTs, paramedics,
where errors occur most frequently in the
pharmacists, or any combination of
pre- and post-analytic phases, POCT
trained healthcare workers, as well as
errors occur primarily in the analytic
laboratory professionals.
phase of testing. This can be related to a
lack of understanding or training of non-
Benefits of POCT
laboratory staff who are typically
Operational benefits of POCT may
involved in POCT, or as a...
include rapid decision making and triage,
as well as the assurance of optimal use of
Read the rest of this and other articles at
professional time. POCT sets the stage for
www.PhysiciansOfficeNews.com
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Microbiology
Outbreaks / epidemics
Methicillin resistant staph aureus
Endocrine testing to guide surgical
therapy
Parathyroid hormone
ACTH
Gastrin
Growth hormone
Sepsis markers
Stroke markers
DNA testing
5