Point-of-care testing (POCT) is traditionally defined as laboratory diagnostics performed at or near the site where clinical care is delivered. POCT thereby combines sample collection, analysis, and reporting of results into a robust integrated testing structure, with a simple user interface. The availability of reliable devices and consolidated tests for patient screening, diagnosis and monitoring has allowed broad diffusion of POCT to the patient's bedside, physician offices, pharmacies, other healthcare facilities, supermarkets, and even into the patient's home. However, current evidence clearly shows that POCT can be subjective, and might even amplify the traditional problems encountered in the preanalytical, analytical and postanalytical phases of the total testing process. This may especially be seen in inappropriateness of the test request, collection of unsuitable biological materials, inaccurate test performances, larger analytical imprecision, unsuitable report formatting, delayed reporting of critical value, and report recording/retrieval. POCT patient care service in the pharmacy can be regarded as a valuable option for the present and future since it might be beneficial for all parties. However, several economic, clinical and regulatory issues should also be addressed before this opportunity can turn into a real advantage for patients and the entire healthcare system. The most appropriate allocation of POCT within the diagnostic pathway, as well as its adjuvant role in screening, diagnosis and monitoring of diseases should also be clearly established in order to prevent widespread and deregulated implementation.
Laboratory testing in pharmacies.
LIPPI, Giuseppe;
2010-01-01
Abstract
Point-of-care testing (POCT) is traditionally defined as laboratory diagnostics performed at or near the site where clinical care is delivered. POCT thereby combines sample collection, analysis, and reporting of results into a robust integrated testing structure, with a simple user interface. The availability of reliable devices and consolidated tests for patient screening, diagnosis and monitoring has allowed broad diffusion of POCT to the patient's bedside, physician offices, pharmacies, other healthcare facilities, supermarkets, and even into the patient's home. However, current evidence clearly shows that POCT can be subjective, and might even amplify the traditional problems encountered in the preanalytical, analytical and postanalytical phases of the total testing process. This may especially be seen in inappropriateness of the test request, collection of unsuitable biological materials, inaccurate test performances, larger analytical imprecision, unsuitable report formatting, delayed reporting of critical value, and report recording/retrieval. POCT patient care service in the pharmacy can be regarded as a valuable option for the present and future since it might be beneficial for all parties. However, several economic, clinical and regulatory issues should also be addressed before this opportunity can turn into a real advantage for patients and the entire healthcare system. The most appropriate allocation of POCT within the diagnostic pathway, as well as its adjuvant role in screening, diagnosis and monitoring of diseases should also be clearly established in order to prevent widespread and deregulated implementation.
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