Point-of-Care Testing in Microbiology: A Mechanism for Improving Patient Outcomes

• Published in: Clinical chemistry (Baltimore, Md.) Vol. 66; no. 1; pp. 124 - 137
• Main Author: Hansen, Glen T
• Format: Journal Article
• Language: English
• Published: Washington American Association for Clinical Chemistry, Inc 01.01.2020; Oxford University Press
• Subjects: Accuracy; Antigens; Care and treatment; Clinical microbiology; Clinical outcomes; Diagnosis; Diagnostic systems; Diagnostic tests; Environmental management; Expenditures; Health care; Health care access; Health care delivery; Health care reform; Laboratories; Laboratory tests; Medical care, Cost of; Medical tests; Microbiology; Nucleic acids; Patient satisfaction; Patients; Quality of life; Tuberculosis; United Kingdom; United States > US
• ISSN: 0009-9147; 1530-8561
• DOI: 10.1373/clinchem.2019.304782

Abstract BACKGROUND Increasingly, demands for improved health and quality of life conflict with the realities of delivering healthcare in an environment of higher expenditures, adherence to test utilization, and patient-centered experience. Patient-centered care is commonly identified as a goal of healthcare delivery, and yet healthcare systems struggle with delivery of care to patients, often failing to identify the seriously ill and capitalize on the predictive qualities of diagnostic testing. Point-of-care (POC) testing provides access to rapid diagnosis and predictive value key to realizing patient outcomes. An evaluation of cost-effective models and the clinical impact of POC testing for clinical microbiology is needed. CONTENT Accurate and rapid diagnostics have the potential to affect healthcare decisions to a degree well out of proportion to their cost. Contemporary healthcare models increasingly view POC testing as a mechanism for efficient deployment of healthcare. POC testing can deliver rapid diagnosis in environments where testing results can be used to direct management during patient visits and in areas where centralized laboratory testing may limit access to care. Nucleic acid assays, designed for POC testing, can match, or exceed, the sensitivity of conventional laboratory-based testing, eliminating the need for confirmation testing. Here, the goals of POC testing for microbiology, applications, and technologies, as well as outcomes and value propositions, are discussed. SUMMARY The combination of rapid reporting, an increasing array of organisms capable of causing disease, actionable resulting, and improved patient outcomes is key in the evolution of POC testing in clinical microbiology.