Pathology Testing at the Point of Patient Care: Transformational Change for Rural Communities

Abstract

Point-of-care (POC) testing is an innovative and revolutionary in vitro diagnostic (IVD) technology that enables the real-time conduct of pathology testing during a patient consultation, facilitating immediate clinical action. When conducted under a quality-assured framework, POC testing is an essential diagnostic tool, and is now well embedded, in primary health care settings in rural communities around the world. POC testing helps bridge the gap in health equity access that exists in geographically isolated rural communities and empowers patients to invest in understanding and improving their own health literacy. Using POC testing networks for chronic, acute and infectious diseases that are currently operating in rural and remote Australia, this chapter explores the operational, clinical and economic benefits that POC testing can deliver, and the lessons learned that have contributed to continuously improved quality of POC testing service delivery. Investment in POC testing and infrastructure by Australian governments, both federal and state, has reaped significant rewards for patients in rural communities. Additionally, translational research in this field has provided insight into how POC testing can be successfully scaled up for broad application in low- and middle-income countries.

Point-of-Care Testing in Rural and Remote Australia: An Emerging Technology to Address Global Health Challenges, Crises and Security

“…Australia has been a pioneer and leader in both the application of POC testing in primary care-particularly services supporting Aboriginal and Torres Strait Islander (now more commonly referred to as First Nations) communities-for the past 25 years. Large-scale POC testing networks (involving close to 100 or more rural and remote First Nations health services) now operate for chronic, acute and infectious diseases across the length and breadth of Australia (Table 1); these are managed for the Australian Government by specialist POC testing network providers including the Flinders University International Centre for Point-of-Care Testing and the Kirby Institute, University of New South Wales, in collaboration with peak First Nations bodies and leadership groups, rather than by traditional pathology laboratories [2,[4][5][6].…”

“…Point-of-care (POC) testing has specific relevance for rural or remote primary care environments, where geographic isolation and long distances from the nearest pathology service can lead to traditional laboratory processes being compromised; sample integrity becomes a major issue due to harsh transport conditions while long turnaround times for results to be returned to remote services result in loss to followup of patient care [4,5].…”