Point-of-care testing (POCT) is making its mark around the world in situations that call for urgent, mobile health needs. Several key scientific sessions at the 71st AACC Annual Scientific Meeting & Clinical Lab Expo in Anaheim, California, are set to showcase this technology’s potential in diagnosing infectious disease and supporting emergency care in these settings. POCT has great potential for improving care delivery and overall patient experience in mobile health, according to Anna Fuezery, PhD, regional clinical chemist at Alberta Health Services in Edmonton, Alberta, Canada. “However, work remains to be done to ensure that POCT in this setting is relevant, affordable, and of sufficient quality to meet clinical needs,” she said.
Fuezery is the moderator for Racing Against Time: Point of Care Testing (POCT) in Mobile Health Settings (32218), which will take place on August 5 from 2:25 to 4;15 p.m. and examine POCT in mobile health settings. “The simplicity, compactness, and analytical robustness of POCT technologies make them ideally suited for mobile health,” according to Fuezery, also a speaker at the session. As a result, mobile health-related POCT applications will continue to grow both in number and complexity. “This does not mean though that POCT will stagnate, or even cease to exist, in other settings. A holistic approach to health encompasses multiple, complementary care delivery models, and POCT will remain an important component of many of them,” she said.
Fuezery will first give an overview of POCT mobile health, then delve into POCT applications in this setting. Specifically, her talk will address glucose, prothrombin time/international normalized ratio, and hematology POCT on the Alberta Stroke Ambulance. Andrew Sargeant, BSc, director of point of care testing services for NSW Health Pathology in New Castle, Australia, will focus on his group’s learnings from Australian paramedic and Hospital in the Home services. Ping Wang, PhD, DABCC, FADLM, associate professor of pathology and laboratory medicine at the Hospital of the University of Pennsylvania in Philadelphia, will round out the session by discussing emerging POC technologies for mobile diagnostics and connected health.
Mobile health has worldwide relevance, “so our session should be of interest to all laboratorians,” said Fuezery. “However, I suspect that each person will take away different actionable information.” Relative newcomers to the field, for example, may focus on considerations that are common across all of the presentations, “as this will be of most help to them in establishing their own mobile health-related POCT program.” More experienced attendees will likely show more interest in areas that relate to the challenges with existing POCT programs, Fuezery offered.
The POCT discussion will continue August 6 when the scientific session Worldwide Challenges in Point of Care Testing (POCT)—A Focus on Molecular POCT (33218) takes place. POCT for infectious diseases has seen recent advancements in accuracy from the development of novel molecular methods. Offering insights from around the world, this session will cover issues specific to POCT implementation, management, and methodologies.
Session moderator and presenter James Nichols, PhD, DABCC, FADLM, a professor of pathology, microbiology, and immunology at Vanderbilt University in Nashville, Tennessee, will discuss the individuals, sites and devices for resolving POCT challenges. Leslie Donato, PhD, DABCC, co-director of hospital clinical labs and POCT at the Mayo Clinic in Rochester, Minnesota, will talk about POC molecular diagnostics, offering perspectives from the United States. Donato will specifically touch on the performance and implementation of POCT in an end-user express care clinic setting. Peter Luppa, MD, a clinical pathologist who heads the core clinical chemistry laboratory of the Instituts für Klinsche Chemie und Pathobiochemie in the university hospital Klinikum rechts der Isar in Munich, Germany, will provide an overview of new guidelines and best practices from Europe. All European Union countries similarly rely on the ISO 22870 POCT standards, Luppa said. “However, in terms of nucleic acid amplification testing, most countries still have no idea about best practices. Only the United Kingdom, the Netherlands, and Germany recommend new process rules that go beyond the ISO norm,” he told CLN Stat.
This session will run from 2:30 to 5 p.m. and is worth 2.5 ACCENT credit hours.
POCT has been instrumental in delivering quick, real-time results for a variety of infections, allowing for one-stop healthcare in which patients are seen, tested on-site and given a prescription in under an hour, Nichols told CLN Stat. Patients no longer have to wait to get a call from the doctor about results or wait several days or even weeks to see their primary care physicians. POCT has revolutionized care for strep infections and provides immediate results for other infections such as mononucleosis, influenza, and HIV while a patient is still being seen by his or her physician. “This allows for treatment and counseling at the same patient visit,” he said.
Some fundamental differences exist between the rapid and molecular POC tests for infectious diseases. “Newer molecular diagnostics, while a little longer in turnaround time, are more sensitive than the antigen-based tests,” Nichols said. This added sensitivity allows for on-site diagnosis of strep infection without having to send a throat swab for confirmatory culture in the laboratory. Rapid antigen tests vary in performance based on the prevalence of influenza strains each year, prompting the Centers for Disease Control and Prevention to recommend annual updates of antigen-based test performance. Concerns also exist about the complexity of performing molecular tests at the POC by nonlaboratory staff and the potential for false positives through carry-over and environmental contamination.
“This session will review the preanalytical, analytical, and postanalytical risks and concerns associated with molecular diagnostics and identify how manufacturers have engineered control processes to detect and prevent common errors when performing molecular tests outside the laboratory,” Nichols summarized.
Want even more POCT? Check out the POCT Pathway, which includes a two-part AACC University bootcamp session (191005/192007) and Managing the Wild Wild West of Point-of-Care Testing (44133/54233).