Susan Matthews

By Brooke Spaeth, Susan Matthews and Mark Shephard

Point-of-care (POC) testing has proven to be a life-changing and transformational technology for patients with acute, chronic, and infectious diseases who live in regional and remote Australia. This technology facilitates patient-centred test results, of equivalent laboratory quality, that are rapidly available to inform clinical and public health decisions with immediate impact on case management. Traditionally, POC testing in high-middle income countries has been most widely used in tertiary or acute care settings to provide rapid diagnostic results for emergency departments, intensive care units, operating theatres and outpatient clinics. However, in low-middle income countries, POC tests are commonly used during antenatal and perinatal care for infectious disease detection, such as Human immunodeficiency virus (HIV) or syphilis, where laboratory services are too expensive, inaccessible, or non-existent. Similarly, the application of POC testing in primary care settings in Australia offers improved healthcare benefits to geographically isolated regional and remote communities, where access to laboratory-based pathology testing is poor and the burden of disease is high. Evidence-based data from research in established primary care POC testing networks for acute chronic, and infectious disease is used to describe the clinical, cultural, and economic effectiveness of POC technologies. Innovative solutions to address current barriers to the uptake of POC testing in primary care settings, which include clinical and cultural governance, high staff turnover, operator training and competency, device connectivity, quality testing, sustainable funding strategies, and the need for regulatory requirements are also discussed. POC testing can provide practical and resourceful opportunities to revolutionise the delivery of pathology services in rural and remote primary care sectors, where the clinical and community need for this technology is greatest. However, several barriers to the scale-up and sustainability of POC testing networks in these settings still exist, and the full potential of POC testing cannot be realised until these limitations are addressed and resolved.

Part of the book: Primary Health Care

By Mark Shephard, Susan Matthews, Corey Markus, Emma de Courcy-Ireland, Lauren Duckworth, Isabelle Haklar, Ellen Kambanaros, Tamika Regnier, April Rivers-Kennedy and Grant White

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.

Part of the book: Rural Health