Point-of-care (POC) or with-patient testing allows physicians and medical staff to accurately achieve real-time, lab-quality diagnostic results within minutes rather than hours. Through the use of portable blood analyzers, testing at the “point of care” streamlines the diagnostic process and helps ensure patients receive the most effective and efficient care when and where it is needed.
POC testing enables staff to make rapid triage and treatment decisions when diagnosing a patient’s condition or monitoring a treatment response. By simplifying the testing process, clinicians can focus on what matters most—providing effective, quality patient care.
With-patient testing offers benefits that extend beyond the bedside. It allows users to improve efficiencies and productivity; simplify processes and procedures; comply with regulatory and performance mandates; and reduce staff burden by bringing the focus back where it belongs: on the patient.
Recent advances have greatly expanded the capabilities of POC testing systems. In addition to offering a growing menu of tests, devices can transmit results wirelessly and in real-time to the patient's electronic medical record for physician review. Some systems have been updated with features designed to help hospitals better manage their POC testing programs and ensure compliance with changing laboratory regulations.
Rapid turnaround of test results is vital to decision-making across a range of healthcare settings. By having access to key test results on the spot, clinicians gain greater control in evaluating and responding to a patient’s ever-changing condition.
Emergency room overcrowding can present problems, including extensive wait times, prolonged patient suffering, patients leaving without seeing a physician, treatment delays for time-sensitive illnesses, and patient dissatisfaction with care. Many EDs are pressured by guidelines specifying accelerated evaluation for patients presenting with specific complaints, including fever, chest pain, and abdominal pain. Implementing with-patient testing may help expedite patient triage by accelerating the availability of critical diagnostic test information, improve patient flow, shorten door-to-disposition times, and reduce length of stay.
Clinical guidelines and facility-determined patient-care protocols create a demand for rapid availability of laboratory testing results. With limited skilled resources and mounting financial pressure, hospital laboratories are under unprecedented pressure to perform quickly. Adoption of POC testing can help relieve pressure on lab technicians by reducing the number of test requests and telephone call-back procedures, thereby freeing them from routine testing, allowing them to focus on more complex, time-consuming tests and high-volume, reference-lab testing.
Critical-care settings are responsible for the management of life-threating conditions where actionable real-time patient monitoring is imperative. By reducing the number of complex steps in the blood-testing process, with-patient testing reduces the potential for errors, accelerates availability of critical test information to help expedite diagnosis and disposition of patients and helps to improve department efficiency. From the ICU to cardiology and cath labs, point-of-care testing can assist facilities with meeting established patient safety protocols while trying to reduce costs associated with prolonged patient treatments.
In the OR, delays can impact patient outcomes, so throughput is paramount and surgical delays are kept under close watch. POC testing can help support the unit’s goal of expeditious care and allow surgeons to respond immediately to unstable patient conditions. In addition, the technology may streamline the blood analysis process (to potentially reduce equipment maintenance) and minimize changes in surgery schedules.
Without POC testing, blood analysis requires time, necessitating leaving the bedside, and may ultimately, increase a patients’ length of stay (LOS). POC testing can help streamline the vent-weaning process, reduce time on vent and decrease LOS.
Without POC testing, blood analysis takes time, requires a significant volume of blood, necessitates leaving the infant’s side, and may ultimately increase length of stay. POC testing may expedite test results, and markedly reduces the volume of blood needed for analysis, and, in turn, reduces the number of transfusions and associated risks.
POC testing enables rapid testing of blood gases, so respiratory therapists can gain a greater degree of control over a patient’s respiratory condition. With many current models, the RT must leave the bedside for blood analysis, taking time away from the patient and necessary breathing treatments. With bedside testing, the RT can remain a more visible and present member of the care team.
Imaging agents (such as iodine and barium) used in radiological procedures can pose serious health risks to patients with certain conditions. To minimize risk, creatinine measurement of renal function is recommended prior to administering imaging agents. Because it may take several hours for the clinical lab to process creatinine tests, POC testing can be used to minimize disruptions and improve efficiencies.
For cancer patients, point-of-care testing can positively impact patient care by allowing the pre-treatment tests required to inform treatment plans to be performed on-site during the same visit. Tests results obtained 15 to 30 minutes prior to treatment enable physicians to make determinations as to what the next course of treatment will be without requiring the patient to return on subsequent visits or make visits to a separate lab. This can help patients to better adhere to their treatment plans and improves the care experience by making treatment more convenient for those with cancer.
Medical facilities beyond the hospital are increasingly adopting POC testing. Examples include urgent care centers, surgery centers, imaging centers, family practices, long-term care facilities, cardiology practices, outpatient clinics, emergency medical services and the U.S. military.
In addition to the obvious benefits to medical staff and patients, there are economic benefits that can result from the adoption of a with-patient testing platform. Improved efficiencies and productivity, simplified processes and procedures, as well as decreased specimen packaging and transportation time can lower the total cost of care. While up to 70% of medical decisions are based on laboratory tests1, they only account for between 3-6% of total patient-care costs.1,2 Costs of POC testing, compared to core laboratory testing (whether centralized or outsourced), can provide even greater decision-making and greater savings.2
Rapid turnaround times, improved decision times, and time-critical decision-making can result in total savings between 8-20% of laboratory costs for facilities that implement POC testing.2 The savings realized due to the decreased cost of waiting for results can be as much as $260USD (€148) per patient.3 For those that implement POC testing, waiting can improve by as much as 46 minutes per patient.4Read full article
1.Forsman, Rodney W. “Why is the laboratory an afterthought for managed care organizations?” Clinical Chemistry Volume 42:5, (1996) 813-8162.
2. Schilling UM. The economic benefits of point-of-care testing. Hospital Healthcare Europe, special supplement. www.hospitalhealthcare.com
3. Schilling UM, Rönnersten A. Laboratory sampling according to triage – how much does it cost? SJTREM 2010;18(Suppl 1):P19.
4. Norgaard B, Mogensen CB. Blood sample tube transporting system versus point of care technology in an emergency department; effect on time from collection to reporting?
A randomised trial. Scand J Trauma Resusc Emerg Med 2012;20:71.
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