The future of decentralised healthcare and diagnostics - Tony Cambridge

The early days of the pandemic required an unprecedented response and Point of Care Testing was expanded to help manage patients.

In our first webinar of the series, Lead Biomedical Scientist Tony Cambridge shares his insights from the frontline and discusses how decentralised diagnostics could deliver long-term benefits for the healthcare system.

In a webinar delivered for the Roche Point of Care Academy, Tony Cambridge outlines a future in which diagnostic services could be delivered within communities—not only in community hospitals, GP surgeries and health centers, but in high street pharmacies, care homes, wellness centres and gyms— disrupting traditional pathways. 

This, Tony suggests, has the potential to improve accessibility, deliver more choice for patients, support personalized care, improve outcomes for certain conditions and even address socio-economic inequalities. The views shared in the webinar have been summarized below.

During the early days of the pandemic, healthcare providers had to adapt to protect patients, staff and beds. The importance of Point of Care Testing (POCT) for diagnosing infected patients, blood gas analysis and the management of comorbidities, such as diabetes, quickly became apparent. New ways of working were established to create hospital red zones, enable rapid procurement and ensure staff were appropriately trained.

The healthcare system continues to face challenges today, from overrun hospitals and emergency departments to rising patient and clinician expectations. With this in mind, Tony anticipates that the future of healthcare delivery will be ‘closer to home’, with a new focus on rapid and decentralised diagnostics. 

Decentralised diagnostics could reduce the burden on secondary care and improve the patient experience, enabling them to seek advice at an earlier point, instead of waiting for symptoms to worsen.

• Backing-up clinical decisions: Clinical decisions are usually based on symptoms, the history of the patient, ongoing conditions etc. Backing this up with a Point of Care Test result could give GPs more confidence in their decision-making, while removing the worry that comes from waiting for lab results.
• Improving patient flow: The hope would be to reduce emergency department attendance, which in turn could reduce hospital admissions and improve the clinician experience. Tony also wants to see care plans and prescriptions provided at the earliest opportunity, further improving patient flow in hospitals.
• Shifting the economic burden: Emergency/secondary care can be expensive. By frontloading the system and putting more diagnostics out into the community, it could be possible to shift the economic burden away from secondary referrals.

Thanks in part to its enhanced role during the pandemic, clinicians are becoming more aware of the utility of Point of Care. However, shifting to a decentralised model will not be without obstacles and Tony acknowledges that there are challenges that will need to be overcome, including: 

• Having the resources available to launch
• Education and public awareness (to highlight where diagnostics are available and what symptoms indicate)
• Walk-ins vs referrals
• Community clinician buy-in
• The availability of clinicians to interpret results, decide on care plans and prescribe.

In terms of quality assurance and control, Tony highlights the need to conduct pilot studies and share knowledge.

• Solving Point of Care Testing challenges? Learnings from the NHS