Point-of-Care testing in home and hospital. 22 nd Biomedical Instrumentation conference. Asst. Prof. Somchat Taertulakarn Allied Health Sciences Faculty Thammasat University. Introduction. Point - of –Care- Testing ( POCT ) P rovides an alternative to laboratory testing
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22nd Biomedical Instrumentation conference
Asst. Prof. Somchat Taertulakarn
Allied Health Sciences Faculty
decentralized analysis, andoff-sit analysis
the most important ‘tools’
that you used when you
first got involved
Early to mid 1990’s
University of Virginia Health Science Center – Original Home of RALS Technology
As POCT evolves, needs will include:
1. It’s not just glucose anymore…
% of Hospitals with POC Devices by Discipline
1999 (510 Hospitals)
2001 (584 Hospitals)
Source: Enterprise Analysis Corp. Stamford, CT
It’s a “Paperless” World!
The Need for Data Management
Look for more patient outcome data
Doctors Nurses Ambulance paramedics
Patients Careers Retail & Leisure centre staff
ICUs Operating theatres
A&E Delivery Suites
General wards Ambulances
GP surgeries Pharmacies
Field hospitals Retail & leisure centers
• Paracetamol, salicylate
• Drugs of abuse
• Occult blood (faecal or
• Urinalysis: blood, albumin,
hCG, ketones, glucose,
leucocytes, pH, nitrite,
• CRP, Infections
• Coagulation, TEG
• Blood gases: pH,
• Na, K, Ca, Cl-
• Urea, Creatinine
• Cholesterol, TGs
• Troponin, CK-MB,
Bedside testing enables:
Director of Pathology
Statement of intent
Hospital controlled POCT
Medical laboratories - Particular
requirements for quality and competence
Non Hospital POCT – Primary care
Point-of-care testing` (POCT) -- Requirements for quality and competence
UKAS Individual Licence
2. What are their benefits over lab based clinical
Depends on clinical context, circumstances & quality of
local POCT management
3. What are their current limitations?
Cost, IT networking capability, ?wireless, ease of use,
insufficiently “idiot-proof” and robust, range of tests
available. Need more non-invasive systems (eg bilirubin)
Little currently on the market for continuous minimally
invasive monitoring (eg for diabetes).
Simplicity of use, miniaturisation, robustness (device &
consumables), costs, IT connectivity, remote lockout for
unaccredited users, decision support software, inclusion of
quality materials within costs, training support. Suppliers to
encourage “whole system” approach to implementation as
part of local diagnostic support.
5. Do they provide clinically useful information? Are they what clinicians want?
Very dependent on appropriate implementation and
consideration of outcomes. Clinicians want ease of use,
reliability, low cost. Managers want improved capacity &
throughput, reduction of beds and staff costs.
required sensitivity and accuracy?
Requirements differ depending on circumstances; quality of
results dependent also on competent use
7. Will POCT diagnostics replace lab based
diagnostics or will it be the other way round?
NEITHER: both are an essential & integral part of
diagnostic provision and will continue to be in the
Major changes in profiles of healthcare provision, IT
developments, analytical technology, requirements of
Clinical Governance and risk management --> blending of
deliveries and need for increasing flexibility of systems.