Toward Sustainable Point-of-Care Testing in Remote Australia–the Northern Territory i-STAT Point-of-Care Testing Program

Abstract

Since 2008 in Australia, the Northern Territory (NT) department of health has been in partnership with the Community Point-of-Care Services unit (now the Flinders University International Centre for Point-of-Care Testing) to deliver quality-assured point-of-care testing on the i-STAT device (Abbott Point of Care, Doncaster, Australia) for the provision of selected pathology services in 33 of its remote health centers in the Territory. A set of agreed research outcomes were developed jointly to assess and validate the operational and clinical effectiveness as well as the analytical safety of point-of-care (POC) testing in remote NT health centers.Across the first 4 years of the program, more than 500 health professional staff have been trained as qualified POC testing operators, and more than 21,250 patient tests on the i-STAT have been performed. Analytical quality for POC testing has met profession-based analytical goals and/or state-of-the-art laboratory performance for most tests. Clinical case studies sourced from the i-STAT central data station (which electronically captured deidentified patient and quality data from all remote services) has confirmed the clinical effectiveness of POC testing for acute and chronic conditions. Community satisfaction with POC testing was validated using qualitative surveys of device operators. Greater than 80% of respondents believed POC testing was more convenient than the laboratory and assisted in the stabilization of patients with acute illness. The Northern Territory i-STAT Point-of-Care Testing Program has therefore proven operationally effective, analytically sound, clinically and culturally effective, and has been well-received by health professional staff. FIGURE 2. Total number of i-STAT patient tests conducted across the first 4 years of operation of the program, split by cartridge type. Shephard et al

Point‐of‐care testing facilitates screening and treatment for anaemia in women and children in rural Pakistan

“…The POCT enabled people to be screened and monitored for anaemia in their home, removing barriers which may prevent people from leaving their homes to attend the clinic. This finding was consistent with the evidence base that POCT can improve access to pathology testing for a wide range of chronic, acute and infectious clinical conditions in remote areas, which has been thoroughly documented in the literature . The results of the QC testing showed that the analytical performance of the HemoCue was sound, providing confidence that the results generated were appropriate for patient care.…”

Sustained Quality and Service Delivery in an Expanding Point-of-Care Testing Network in Remote Australian Primary Health Care

“…Detailed overviews of the NT POCT Program from 2008 to 2015 have been published elsewhere. [7][8][9] Methods specific to the NT POCT Program from 2016 to 2019 are documented below. Top End regions and Primary Health Care Centres in the Ngaanyatjarra Lands.…”

“…Since 2008, the Northern Territory Department of Health, in collaboration with the Flinders University International Centre for Point-of-Care Testing, has supported the Northern Territory Point-of-Care Testing Program (NT POCT Program) within the Northern Territory. 7,8 The NT POCT Program commenced in August 2008 using the Abbott i-STAT (Abbott Point of Care, Princeton, New Jersey) at 33 remote Northern Territory primary health care services. 8 The benefits of point-of-care testing in remote communities led to the rapid expansion of the NT POCT Program.…”

“…In the first 4 years of the program, more than 500 staff were competent i-STAT point-of-care testing operators, the total number of i-STAT tests performed had increased to 21 250, and the analytical test quality remained satisfactory compared with laboratory benchmarks. 7 By 2015, the NT POCT Program had effectively doubled to include all 72 remote health services within the Northern Territory. 9 In 2016, 8 remote health services from the Ngaanyatjarra Lands in the Western Desert region of Australia were also enrolled into the NT POCT Program (Figure 1).…”

Clinical and Operational Benefits of International Normalized Ratio Point-of-Care Testing in Remote Indigenous Communities in Australia’s Northern Territory

“…10 Since 2008, the NT Department of Health has partnered with the Flinders University International Centre for Point-of-Care Testing to deliver quality-assured POCT on the i-STAT device (Abbott Point of Care, Doncaster, Australia) through NT's remote health center network. 11,12 This article reports on the operational and clinical benefits of INR testing on the i-STAT in the NT POCT Program from 2008 to 2014.…”