Point-of-Care Testing and its emerging trends
What is Point-of-Care Testing?
Point-of-care testing (PoC testing) is known to be the medical testing performed by professionally trained healthcare (non-laboratory) workers at or close to the location of patient treatment (NHS). These examinations frequently include blood and urine tests. At the patient’s site or close by, PoC testing aims to collect samples and produce reliable results in a brief amount of time. As a result, PoC testing can be used in a variety of primary care, community, and secondary care settings, allowing for convenience, quicker results, higher access and possibly lower costs.
Currently, different types of point-of-care testing equipment are available on the market, varying from straightforward dipsticks for urine, portable glucose metres, or complex benchtop analysers like those used to measure blood gases in critically unwell patients. Blood glucose monitoring and at-home pregnancy tests are considered to be the most often used point-of-care testings. For persons using the anticoagulant warfarin, other frequent tests include those for haemoglobin, haemoglobin A1c, and prothrombin time/international normalised ratio (PT/INR) (Lab Tests Online UK).
Point-of-Care testing has the potential to challenge established procedures and promote better patient outcomes, allowing patients to receive early diagnostics before visiting hospitals in a shorter time, reducing workload for laboratory staff and physicians, enabling first responders to collect patient diagnostic data before hospital trip with minimum admissions, and possibly other financial benefits.
For example, Point-of-Care testing proves great benefits in the diagnosis for patients with Ebola, as early isolation and care of patients with suspected symptoms are keys in preventing this deadly disease, in highly remote areas. Using the traditional laboratory methods, including collecting samples, transporting samples to laboratory with PCR-based tests, result communication back to sites, could take more than 6 days for the results to be received, which then could be too late for the patients. However, the WHO-approved ReEBOV Antigen Rapid Test Kit could detect Ebola protein, instead of nucleic acid, in less than 15 minutes, correctly identifying about 92% of Ebola infected patients and 85% of those not infected with the virus.
Microfluidic chip with integrated optics features (Photo: Micro Systems)
How big is the market for Point-of-Care Testing?
The necessity for decentralised healthcare services, growing demand for fast testing, and technological improvements have all contributed to the industry’s tremendous rise during the past decades. The Global Point of Care (POC) Diagnostics/Testing Market was estimated to be worth $43.2 billion in 2022, and a recent report projects the market to grow to $98.13 billion by 2030. The market is expected to expand at a CAGR of 10.8% from 2023 to 2030.
The rising prevalence of chronic illnesses throughout the world is one of the main long-term market drivers for PoC Diagnostics testing. The importance of PoC testing has also been further emphasised by the recent appearance of the COVID-19 pandemic, as rapid testing options are vital in rapidly identifying sick people and helping infection control measures effective. In addition, the integration of digital health presents great opportunities for the future of PoC Testing, as with the streamline of data management, patient outcomes can be improved, and the whole healthcare experience can be improved with through continuous communication between patients, medical professionals, and laboratories, promoting improved care coordination and data-driven decision-making.
Innovations and Movements in Point-of-Care Testing
Technology is revolutionising the diagnostics sector, with exciting innovations taking place globally.
Artificial Intelligence (AI) is being widely integrated in Point-of-Care Diagnostics for testing. By integrating machine learning (ML) onto Point-of-Care testing devices (Edge interference), data can be collected and processed locally rather than on the cloud, at the point of care. Due to the accessibility of specialised hardware, edge inference is now practical and allows for real-time processing, greater data security, and a decreased dependency on network quality. For instance, the technology is used by a portable retinal camera created in Taiwan to identify diabetic eye illness, enabling primary carers to make diagnoses that would traditionally be made by an ophthalmologist, with the same accuracy level but 10 times faster than a rival cloud-based product and do not necessitate transportation to an expert ophthalmologist. Another example is the use of AI in point-of-care cardiac ultrasound exams, such that medical workers who lack sonography knowledge may nevertheless acquire cardiac ultrasound pictures at Point-of-Care testing with the help of the UltraSight real-time AI guiding programme. According to UltraSight, the technology will give hospital personnel the ability to progress patient triage and treatment with more effectiveness and clinical assurance. By introducing cardiac ultrasonography into local communities, it can also improve access to care for people with chronic heart disease, potentially enhancing patient adherence to crucial therapies.
The Covid-19 has proven to us the importance of remote healthcare, where patients can receive services without getting access to healthcare facilities. The integration of telehealth in Point-of-Care testing helps advance remote patient diagnosis and monitoring, removing the need for travelling and reducing the long waiting time for appointments. For example, the miniaturised diagnostic platform developed by PixCell Medical for CBC test helps patients receive the results within 5 minutes, using one drop of blood, without the need for needle and minimised anxiety for children and parents.
There are also innovative breakthroughs in the field of Point-of-Care testing with the use of microfluidics and lab-on-a-chips. For example, a potential tool for assessing nutritional status at the point of care is the Cornell NutriPhone, as it takes around 15 minutes to determine the levels of iron, vitamin A, vitamin D, vitamin B12, and vitamin C from a single drop of blood. Major OEMs have also developed PoC devices that can run multiple tests on one cartridge, in less than an hour, in the doctor’s office, giving huge benefits to patients as they could have discussions with doctors about their situations in such a shorter time.
Moving forward, education is a key factor in enabling the applications of Point-of-Care testing. Online materials like the knowledge portal, www.myPOCacademy.com, with content developed in collaboration with an outside expert faculty, offers a variety of multimedia learning alternatives and professionally approved training. The website’s clinical specialties covered include cardiovascular disease, diabetes, and respiratory health.
Microfluidics features (Photo: Micro Systems)
Challenges of Point-of-Care Testing
Point-of-Care testing will probably become increasingly important as people are urged to get more involved in their own healthcare, especially for those who have limited access to healthcare facilities. However, there are some disadvantages regarding this system, including differences in methodology between PoC testing and laboratory systems (due to underlying measurement technology), the results’ reliability (user errors), and the management and storage of supplies and reagents. Point-of-Care tests must, however, be a part of a testing continuum that also includes centralised clinical laboratories and a team of healthcare experts in order for people to obtain the best possible treatment utilising these tests, to avoid any undesirable consequence.
The management challenges for PoC testing lie in the connectivity between PoC devices and laboratory information systems and operator training. With suitable softwares integrated in the PoC diagnostic device, real-time results could be automatically updated to the carers or the patients’ health records, hence maximising the benefits of quick results, and minimising human errors in entering the results manually. Operators using PoC testing devices also need to receive thorough training and certifications to minimise any human error in conducting the tests, and to ensure that they are ready to support the services for the local community and health centres. Building a network of PoC testing systems within regional areas could also increase support for people in need, improve the cost-effectiveness of staff training and operation, and maximise the connectivity between centres.
Another challenge for PoC testing is the design of PoC testing devices. Designs need to consider the end-users (patients, physicians , doctors, etc.) as the focal point of the design, and integrate usability engineering and human factors into the service and product design processes, hence they will be able to find and remove elements that have an impact on the overall accuracy, efficacy, user happiness and safety. By employing techniques such as design research (ethnographic research, cognitive science), experience designers could cover the physical and digital interactions between the users and the PoC testing devices, creating more efficient, innovative designs from the very first stage, to solve the real problems that end-users face when using PoC tests. The integrated human-centred design approach can also shorten the time to market and development costs by minimising iterations at later stages.
The recent changes in lifestyles after the Covid-19 has proved the rising importance for the use of Point-of-Care tests, especially for those who have limited mobility, for in areas with limited access to complex laboratories. There are still a number of challenges for the development of remote diagnostics, mainly in R&D and infrastructure, it will not be long until Point-of-Care testing devices are available in patients’ homes, or in local clinics in the most remote areas.
Micro Systems’s vast know-how in design, ultra-precision micro machining capabilities and expert knowledge in micro moulding technology allow us to manufacture advanced microfluidic moulds with tolerance as low as +/-0.001mm, with integrated optics. We have a dedicated micro moulding facility, and have ISO13485 and ISO9001 certifications. For more information, please Contact us or visit our website.