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Point-of-Care Testing

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What is point-of-care testing?

Hand-held deviceIn the early days of medicine, few medical tests existed that were done at the patient's bedside. By the 1950s, automated technologies meant centralized clinical laboratories could run large numbers of tests at low cost. It became common to send samples away to laboratories and then wait days to weeks for results.

As the need for faster test results has grown and certain testing devices have become portable and easy to use, medical testing has evolved once again. Today, results from clinical laboratories remain a crucial component of your healthcare, but they are now complemented by tests performed outside of the laboratory, wherever you are.

Point-of-care testing spans so many areas of medicine that it is best defined by where it's done – anywhere outside the centralized laboratory – rather than by the kinds of tests that are performed. It may be referred to by many different names, such as near-patient testing, remote testing, satellite testing, and rapid diagnostics. In general, point-of-care testing encompasses any tests that are performed at or near a patient and at the site where care or treatment is provided. Results are typically available relatively quickly so that they can be acted upon without delay.

Point-of-care tests can happen in a wide variety of locations: in your home, at a healthcare practitioner's office, in the emergency department, in an infectious disease containment unit, in ambulances, at an accident scene, in the military, in the radiology department, on a cruise ship, or even on the space shuttle. And a wide variety of people can perform point-of-care tests, including laboratory professionals, emergency first responders, radiologists, doctors, nurses, physician assistants, or other healthcare practitioners. They may even be done by yourself, sometimes called "self-tests" or "home tests."

benchtop deviceDevices for point-of-care tests come in an array of forms. They may use basic dipsticks as with urinalysis, handheld devices like glucose meters, or sophisticated molecular analyzers to detect infectious diseases. A healthcare practitioner may use a handheld device to perform a test at a patient's bedside. Alternatively, that healthcare practitioner may collect a blood sample from the patient and walk the sample down the hallway to a satellite lab, where the sample is processed and tested on instrumentation. Both examples are considered point-of-care testing.

And the same type of point-of-care device may be used by a healthcare practitioner and a "lay person" such as yourself. For example, glucose meters are used by healthcare practitioners in hospitals to monitor patients in intensive care units. Glucose meters can also be used by diabetics at home to monitor levels and to adjust their insulin if necessary. Though the regulation and oversight of the use of these devices may differ when healthcare practitioners use them as opposed to the general public, they are more or less comparable devices.

The most common point-of-care tests are blood glucose monitoring and home pregnancy tests. Other common tests are for hemoglobin, fecal occult blood, rapid strep, as well as prothrombin time/international normalized ratio (PT/INR) for people on the anticoagulant warfarin. As medical care evolves to become more consumer-focused, point-of-care testing will continue to be an important way to perform medical testing. However, for you to receive the highest quality care by using these tests, it's important that point-of-care tests are part of a testing continuum that includes centralized clinical laboratories and a team of healthcare practitioners.

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