Why point-of-care testing is vital to medical diagnostics

December 20, 2024

The science and innovation driving point-of-care (POC) testing have evolved dramatically since 1974 when the first glucometer designed to measure blood glucose at the point of care was introduced. Today, as the standard-bearer of the test-to-treatment approach, POC testing helps clinicians diagnose acute illnesses, such as respiratory infections, and monitor conditions like diabetes and cardiovascular disease for optimal care management. These reliable, lab-quality tests enable testing to be performed near the patient with results available in less than 30 minutes, in most cases.¹

Embedded in various healthcare settings, POC testing has notable benefits. The technology’s turnaround time accelerates time-critical clinical decisions and allows for early, targeted intervention that improves patient outcomes. Testing at the point of care also enables confident, informed healthcare decision-making that supports antimicrobial stewardship. Enhancing experiences for both patients and staff, POC testing streamlines practice workflows for greater efficiency. 
 

Improved patient care

A recent study performed in the emergency department at the University of California Davis Medical Center showed that implementation of a rapid multiplex test (test that detects more than one pathogen) at the POC reduced the median order-to-result turnaround time for SARS-CoV-2 diagnosis by more than 11 hours.²

In addition, accurate diagnostic testing at the POC can help patients avoid complications from unnecessary treatment, as well as additional testing they don’t need. For example, patients who test positive for influenza in the emergency department may be less likely to have invasive blood count and culture, urine testing, and chest radiographs performed.²

Also related to clinical outcomes, patient follow-up after laboratory-based testing continues to be a significant barrier in both the United States and globally. In response, the World Health Organization (WHO) Alliance for Patient Safety has prioritized patient follow-up. The alliance has issued guidelines that support the use of POC testing for infectious diseases, including sexually transmitted infections (STIs), tuberculosis and others.¹
 

Responsible stewardship

Providing a downstream public health benefit, POC testing helps stifle the emergence of antibiotic-resistant organisms. The number of lives lost around the world due to infections that are resistant to the medications intended to treat them could increase by nearly 70%, a new study projects, further demonstrating the burden of the ongoing superbug crisis.³

STI testing and treatment patterns in the U.S. offer a case in point. In a real-world study analyzing more than 23 million instances of patients presenting with symptoms of a urogenital condition, the study showed that 89% of patients who received antibiotics received their treatment within the first three days of their initial appointment.⁴ These treatments were likely given before results from CT (Chlamydia trachomatis)/NG (Neisseria gonorrhea) testing would be available. These study findings point to presumptive treatment for diseases that should be tested for and treated accordingly, removing the potential of undermining antimicrobial and diagnostic stewardship. For some STIs, including CT, NG, MG (Mycoplasma genitalium), and TV (Trichomonas vaginalis), definitive diagnosis is needed to make treatment decisions due to overlapping symptoms.⁵  The study also revealed that even for individuals who showed symptoms, fewer than 2 in 10 received CT/NG testing,⁵  demonstrating the underutilization of STI testing.

Successful antimicrobial stewardship is a complex global issue relevant across a variety of diseases and conditions. In the diagnosis and treatment of respiratory viruses, the availability of Clinical Laboratory Improvement Amendments (CLIA)-waived molecular POC testing assays for influenza has made a demonstrable difference in the clinical management of respiratory illnesses. A study that compared prescribing patterns of an urgent care center using the cobas^Ⓡ liat influenza A/B assay to other urgent care facilities using rapid influenza diagnostic tests (RIDTs) provides just one example. Published in the Journal of Clinical Microbiology, the study showed an improvement in antiviral prescribing practices when PCR POC test results were available during the clinic visit.

“Antimicrobial stewardship is driven by good diagnostic stewardship, and this extends to more than just respiratory viruses,” Heaney said. “For example, having additional molecular point-of-care testing options for STIs would greatly impact our ability to drive better antibiotic stewardship.”

Enhanced workflow efficiency

With laboratory and medical staffing shortages taking a toll on nearly every area of healthcare, CLIA-waived POC testing has the potential to streamline practice and administrative workflows and reduce time-intensive tasks. Testing at the point of care eliminates preparation and transportation of samples to off-site laboratories, and the need for follow-up scheduling decreases when patients are tested and treated during the same visit.¹ Simple, easy-to-use molecular POC tests help alleviate staffing shortages, freeing up laboratory personnel to focus on tasks that require more expertise. 

POC testing is evolving

Nearly 50 years after the introduction of that first glucometer, POC testing continues to evolve to meet the needs of patients and providers alike. The COVID-19 pandemic highlighted the critical role and importance of having accurate, lab-quality results available while the patient is still present at the point of care.¹

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