When you should and shouldn’t use Point of Care Testing

• Point of Care Testing (POCT) delivers the greatest value when results directly influence clinical decisions, but works to complement not replace central laboratory testing

• Understanding the benefits and limitations of POCT helps clinicians and laboratory leaders choose approach based on urgency, complexity, quality requirements, and cost

• Strong laboratory governance, quality control, and data integration are essential to ensure POCT improves patient care rather than introducing risk or inefficiency

Point of Care Testing (POCT) refers to diagnostic testing performed at or near the site of patient care—such as the bedside, in clinics, or in community settings—rather than in a centralized clinical laboratory.¹ By bringing testing closer to the patient, POCT can shorten turnaround times (TAT) and support faster clinical decision-making when timely results are essential. Its growing adoption reflects clear advantages, including accessibility, portability, workflow flexibility, and expanding test menus designed for use outside the laboratory.²

However, POCT isn’t a universal replacement for laboratory testing. When used without appropriate oversight, validation, or clinical justification, it can introduce quality, interpretation, and cost risks that undermine patient care.² The central question, therefore, is not whether POCT is beneficial, but when it is the right choice compared with central laboratory testing. Understanding its benefits and limitations helps laboratory leaders and clinicians apply POCT strategically so that it complements, rather than replaces, traditional laboratory methods.

POCT delivers diagnostic testing directly to the patient, enabling rapid results without reliance on a central laboratory. It often serves as a frontline tool for initial assessment and triage, helping clinicians guide immediate treatment decisions. Common use settings include hospital bedsides, emergency departments, intensive care units, outpatient clinics, pharmacies, ambulances, and disaster or military response environments.³

Advances in biosensors, miniaturized electronics, and microfluidics have driven POCT’s evolution from early “near-patient testing” of blood samples in the 1950s to today’s compact, rapid devices.¹

Unlike traditional laboratory testing, which requires sample transport and multi-step processing, modern POCT delivers actionable results on-site.¹ This approach supports faster, more responsive care while complementing the essential role of central laboratories for complex or high-volume assays.

By bringing testing to the patient, POCT can turn minutes into meaningful decisions, enabling faster treatment and more efficient workflows. But the advantages of POCT extend beyond speed to accessibility and patient experience:^3,4

• Faster TAT: Results are available within minutes, reducing delays from sample transport and laboratory processing, critical in emergency and acute care.
• Immediate decision-making: Clinicians can initiate or adjust treatment during the patient encounter, without waiting for follow-up results.
• Improved patient flow: Faster testing reduces bottlenecks, minimizes hospital visits, and streamlines movement through high-volume care areas.
• Access in remote or resource-limited settings: POCT extends diagnostics to rural clinics, mobile units, and disaster or military settings.
• Enhanced patient experience: Near-patient testing reduces repeat visits and delivers answers quickly, supporting satisfaction and engagement.
• Operational benefits: Portable, easy-to-use devices with expanding test panels can reduce cumulative healthcare costs when integrated into appropriate clinical pathways.

Despite these advantages, POCT isn’t always the best option. Clinicians and lab leaders must weigh factors such as complexity, quality control (QC), and cost before deciding whether to deploy POCT or rely on central laboratory testing.

POCT is most impactful in scenarios where rapid results can directly influence patient management—the “green light” for its use.

• Emergency and critical care: POCT provides immediate biochemical and microbiochemical assessments at the bedside, supporting rapid decisions in life-threatening situations like sepsis or severe infections. Biomarkers like electrolytes, lactate, creatinine, and C-reactive protein can guide urgent interventions.⁵
• Chronic disease management: For conditions like diabetes, POCT for blood glucose or hemoglobin A1c (HbA1c) enables timely therapy adjustments in hospitalized or outpatient settings, facilitating patient-centered discussions and proactive treatment.^6,7
• Infectious disease and public health: POCT allows immediate diagnosis and on-the-spot treatment of infectious diseases such as sexually transmitted infections (STIs) and COVID-19, helping reduce transmission.^8,9
• Remote, rural, and resource-limited settings: POCT extends diagnostic access to rural clinics, mobile units, and disaster zones where central laboratories are unavailable, ensuring efficient interventions.³

While point of care testing offers speed and convenience, it’s not appropriate for all scenarios—the “red flag” for cautious use. 

• Complex or specialized testing: Assays requiring advanced instrumentation, multiplexing, or high analytical precision, such as complex molecular diagnostics or tumor marker panels, are better suited to central laboratories with established infrastructure, expertise, and quality assurance (QA).¹⁰
• High-volume, low-cost throughput: Routine screenings or large-scale population testing are often more efficient and cost-effective in centralized labs. POCT in these settings can be logistically challenging and more expensive per test.^2,11
• QC and training limitations: POCT devices require strict adherence to calibration, maintenance, and operator competency. In environments where consistent training, internal QC, or proficiency testing can’t be ensured, result reliability may be compromised.^12,13
• Overuse without clinical benefit: Routine or repeated use of POCT in stable patients may not influence care decisions and can increase resource use. Repeated bedside testing for stable chronic patients or routine daily panels in inpatients may offer minimal clinical advantage compared with scheduled laboratory testing, while consuming additional resources.^11,14

Laboratory oversight is essential to ensure point of care testing delivers reliable results and supports high-quality patient care. Clinical labs provide the expertise needed to select appropriate devices and assays, conduct rigorous validation and verification studies, and establish standardized QC and QA protocols aligned with ISO 15189.² They also manage connectivity and data integration with laboratory information systems (LIS) to maintain traceability and reduce manual errors, and oversee staff competency and training, including ongoing assessment and documentation.⁴

Without structured lab involvement, including regular audits, calibration oversight, and a formal governance framework, POCT quality can suffer, particularly when operators lack formal laboratory training.^1,2 By partnering with clinical stakeholders and leading governance committees, labs ensure POCT is used appropriately, maintained to professional standards, and integrated into broader diagnostic strategies.

Effective governance of POCT relies on robust connectivity and integration with LIS and electronic health records (EHRs). Integration ensures result traceability, complete audit trails, and continuous quality monitoring, including compliance with internal and external QC standards.¹⁵ Centralized data capture allows laboratories and clinicians to track trends, identify outliers, and evaluate patient results over time, enhancing population-level insights. 

Integration also facilitates operator accountability, ensures timely calibration and maintenance of records, and reduces transcription errors that can compromise patient safety.¹⁵ By ensuring that POCT data is automatically incorporated into the patient record, labs preserve continuity of care, allowing any clinician accessing the record to make informed decisions. In short, “data in the system” is critical: It transforms individual test results into actionable intelligence that supports strategic use of POCT.

When deciding whether to use POCT or central lab testing, a structured, evidence-based approach helps ensure appropriate and cost-effective utilization:

1. Is it time critical? POCT is most valuable when rapid results directly influence urgent clinical decisions.⁴
2. Will the result change immediate management? Use POCT if results will guide treatment initiation, modification, or escalation at the point of care.⁴
3. Can quality be assured? Confirm that devices are validated, operators are trained, and QC and QA procedures are in place to maintain result reliability.¹⁵
4. Are there cost-effective alternatives in the laboratory? Consider whether the same test can be performed centrally with lower cost, higher throughput, or broader analyte panels without compromising care.¹¹
5. Are workflow and connectivity supported? Ensure POCT devices integrate with LIS/EHR systems to maintain traceability, audit trails, and clinical documentation.¹⁵

Applying this framework positions POCT as a strategic complement to central laboratory testing, rather than a default replacement, aligning speed, accuracy, and cost with patient care priorities.

Point of care testing delivers greatest value when used strategically—where rapid results inform immediate decisions, improve patient flow, or expand access in remote settings. It’s not a replacement for central laboratories, which remain essential for complex and high-volume testing.^1,2,4 When governed through strong lab leadership, QC, and data integration, POCT functions best as a complementary element of an integrated diagnostic strategy, supporting balanced, high-quality care.¹⁵