Decentralised point-of-care testing for acute, chronic and infectious disease - benefits and challenges

ABSTRACT

The COVID-19 pandemic has reinforced Australia's need for diagnostic testing frameworks that are well-prepared, well-resourced, responsive, appropriately governed, scalable, interdisciplinary and collaborative.1 Point-of-care (POC) technologies offer diagnostic solutions capable of delivering individual, community and public health benefits in settings where a) laboratory testing is not available, b) rapid turn-around time is needed, c) high loss to follow-up occurs in high-risk populations with standard of care cascades and/or d) disease transmission rates exceed laboratory response capacity. Key translational research derived from collaborative point-of-care testing networks for a) diabetes management (238 remote health services;3,233 operators;172,069 HbA1c and 51,379 urine albumincreatinine ratio tests), b) acute care (106 remote health services;2,279 operators;32,950 blood gas, 32,689 cardiac troponin, 46,418 urea/electrolytes, 48,193 international normalised ratio tests), c) hepatitis C virus (HCV) (41 sites;110 operators;5,733 HCV tests;4,978 RNA, 755 antibody), d) syphilis screening (156 sites;1,412 operators), e) chlamydia, gonorrhea or trichomonas (51 sites;795 operators;>50,000 tests) or f) COVID-19 (101 remote health services, 733 operators, 72,624 tests) will be used to highlight operational, clinical, public health, and economic benefits of POC testing. Challenges associated with scale-up and accreditation pathways for decentralised POC testing will be discussed. Reference 1. Revised Testing Framework for COVID-19 in Australia, March 2022 Version 2.1. Communicable Disease Network Australia and Public Health Laboratory Network. Copyright © 2022