Point-of-care testing (POCT) has long been associated with one compelling advantage: speed. By moving selected diagnostic tests closer to the patient, results can be available during the clinical encounter rather than relying on samples being transported to a central laboratory and results returned later.
But the potential of point-of-care diagnostics is becoming much broader than simply delivering individual test results more quickly.
Advances in diagnostic technology are making increasingly sophisticated testing possible in compact systems. At the same time, healthcare is evolving towards more flexible models of delivery, with greater emphasis on community-based care, more efficient patient pathways and making appropriate services accessible outside traditional hospital settings.
The result is an important question for healthcare providers: what diagnostic capability could we bring closer to the patient, and what might that enable us to do differently?
It is a question that goes to the heart of how Haval Ozgun, General Manager, Division of Rapid Diagnostics at NHS South West London Pathology, sees the future of diagnostics:
“The future of healthcare is not just about delivering faster results, it's about bringing high-quality diagnostics closer to the patient.”
POCT is entering a new phase
Point-of-care testing is not new. Across healthcare, established POCT technologies already allow clinicians to perform individual tests or relatively focused groups of tests closer to patients.
What is changing is the breadth and sophistication of the diagnostic capability that can potentially be delivered in this way.
Traditionally, accessing haematology, clinical chemistry and immunoassay testing at the point of care could involve multiple analysers, different consumables and separate workflows. A new generation of compact, multi-disciplinary diagnostic platforms is beginning to challenge that model.
The Ehome EHBT-50 MiniLab is one example. Combining 7-part differential haematology, biochemistry and immunoassays within a single compact platform, it demonstrates how substantially the capabilities of decentralised diagnostic technology are evolving.
Haval describes the technology as:
“A significant step forward by combining haematology, biochemistry, and immunoassays into a single portable platform.”
For BHR Biosynex, this represents an important evolution in what point-of-care technology can potentially deliver. Hadjer Bouchair, Quality & Regulatory Affairs Manager, BHR Biosynex, comments:
“We are moving beyond the idea that point-of-care testing is simply about performing an individual test more quickly. The exciting development is the increasing breadth of diagnostic information that can be made available closer to the patient. That creates opportunities to think differently about where testing takes place and how diagnostics can support the wider patient pathway.”
Rather than asking only whether a particular test can be performed closer to the patient, healthcare providers can increasingly consider whether a more comprehensive range of diagnostic information could be made available where clinical decisions are actually being made.
Why location matters
For many diagnostic investigations, the central laboratory will continue to be the appropriate setting, providing the scale, specialist expertise, extensive test menus and highly controlled processes required by modern healthcare.
But not every clinical pathway necessarily benefits from every diagnostic decision being separated from the patient encounter.
Where appropriate, access to diagnostic information during or close to that encounter has the potential to change the way a pathway works.
It can allow a clinician to consider the result alongside the patient's presentation, history and other information while they are still receiving care. Depending on the pathway and tests involved, this may help inform decisions about further investigation, treatment, referral or follow-up.
This is why the evolution of POCT is about more than reducing turnaround time.
It is about positioning appropriate diagnostic information closer to the point at which it can inform a clinical decision.
Haval highlights this potential in his assessment of the EHBT-50:
“This innovation has the potential to transform point-of-care testing by enabling clinicians to make faster, more informed decisions, improving patient outcomes…”
As healthcare services continue to explore ways of delivering more care in community, outpatient and other decentralised settings, the location of diagnostics becomes an increasingly important part of the conversation.
If patients are receiving care in different places, healthcare providers also need to consider where the diagnostic information supporting that care should be generated.
As Hadjer explains:
“Healthcare is increasingly being delivered across a much wider range of settings. Diagnostics needs to evolve alongside that change. The opportunity is to make appropriate testing available closer to where patients are receiving care, helping healthcare professionals access the information they need to make timely, informed decisions.”
Breaking down diagnostic silos
One of the particularly interesting developments within next-generation POCT is the convergence of diagnostic disciplines that have traditionally required separate analytical systems.
The EHBT-50 MiniLab combines three areas within one platform:
Haematology – including 7-part differential analysis.
Biochemistry – providing access to clinical chemistry testing within the same system.
Immunoassays – adding another diagnostic discipline without requiring a separate analyser.
Bringing these capabilities together potentially simplifies more than the physical footprint alone. Multiple standalone systems can mean multiple workflows, maintenance requirements, training considerations and consumable inventories. A multi-disciplinary platform offers a different approach: consolidating a broader range of diagnostic capability into a single system.
This could be particularly significant in environments where space, staffing or testing volumes make the installation of several traditional analysers impractical.
It also changes the question healthcare providers can ask when evaluating POCT.
Instead of:
“Which analyser do we need for this test?”
the conversation can begin to move towards:
“What diagnostic capability do we need at this point in the patient pathway?”
That distinction matters.
The future opportunity for POCT may not lie simply in relocating individual laboratory tests. It could increasingly involve designing diagnostic provision around the clinical setting and the decisions that need to be made there. According to Hadjer:
“The ability to bring different diagnostic disciplines together on one platform is particularly interesting because it allows us to think about POCT in terms of clinical need rather than individual technologies. It opens up a much broader conversation about what diagnostic capability could appropriately be delivered outside the traditional laboratory environment.”
Complementing the central laboratory
The growth of decentralised diagnostics should not be interpreted as a move to replace central laboratories.
Quite the opposite.
Central laboratories remain fundamental to modern healthcare, delivering enormous analytical capacity, specialist testing, expert interpretation and sophisticated quality systems that cannot simply be replicated in every care setting.
The more important question is how centralised and decentralised diagnostics can work together effectively.
As Haval observes, advanced POCT has the potential to contribute to:
“…reducing pressure on central laboratories, and expanding access to advanced diagnostics wherever care is delivered.”
Used appropriately, decentralised testing may allow selected investigations to take place closer to the patient while central laboratories concentrate their resources and expertise where they add the greatest value.
But increasing the capability of POCT also makes governance more important, not less.
A sophisticated analyser located outside the central laboratory still needs to operate within an appropriate clinical and quality framework.
That includes considerations such as operator training and competency, internal quality control, external quality assessment where appropriate, equipment maintenance, traceability, result management, connectivity and data governance.
There also needs to be clarity around what happens once a result is generated. Who reviews it? How does it enter the patient's record? What thresholds trigger escalation or referral? When is confirmatory laboratory testing required? Who has clinical responsibility for acting on the result?
These questions are fundamental to effective POCT and Hadjer makes this additional point:
“Decentralising testing does not mean decentralising standards. As diagnostic capability moves closer to the patient, robust quality management, appropriate training, connectivity and clearly defined clinical pathways remain essential. Innovation and governance have to develop together if we are going to realise the full potential of point-of-care diagnostics.”
The technology can make decentralisation possible. Governance and carefully designed clinical pathways make it valuable.
Connectivity will therefore become increasingly important as point-of-care systems become more sophisticated. The aim should not be to create isolated pockets of diagnostic information, but to ensure that appropriate results can form part of the wider patient record and healthcare pathway.
The future is consequently unlikely to be a choice between “laboratory” or “point of care”.
It is more likely to involve an increasingly connected diagnostic ecosystem in which testing takes place in the most appropriate setting for the patient and clinical pathway.
Where could this take healthcare?
Once advanced diagnostic capability becomes more portable, the range of environments in which it could potentially add value expands considerably.
Primary care may present opportunities where access to a broader range of diagnostic information during or close to a consultation could support clinical decision-making, referral and ongoing patient management.
Community diagnostics are an obvious example. As healthcare systems seek to provide appropriate services closer to people's homes, access to a broader range of diagnostics could support the development of new community-based pathways.
Urgent and unscheduled care may present other opportunities where timely access to appropriate diagnostic information could help clinicians make decisions while the patient is still present.
Outpatient and ambulatory settings could potentially benefit where testing forms part of a consultation or treatment pathway and obtaining results during the same visit could improve efficiency.
Private clinics and hospitals may see value in bringing a broader diagnostic capability in-house, particularly where rapid access to results or flexibility of service provision is important.
There may also be opportunities in other appropriately governed decentralised healthcare environments where access to central laboratory infrastructure is limited or where patient pathways could benefit from diagnostic information being available closer to care.
The appropriate model will not be identical in every setting. Test volumes, clinical requirements, staffing, governance, connectivity and economics all need to be considered.
That is why the most important conversation about next-generation POCT is not simply about where an analyser can physically be placed.
It is about where access to diagnostic information can genuinely improve a patient pathway.
From faster results to a different model of diagnostics
Speed will always be one of the important advantages associated with point-of-care testing.
But it may no longer be the most interesting one.
As technologies such as the EHBT-50 MiniLab bring increasingly sophisticated and multi-disciplinary diagnostic capabilities into compact platforms, healthcare providers have an opportunity to think more broadly about the role diagnostics plays within the patient journey.
Can appropriate testing move closer to clinical decision-making?
Can diagnostic disciplines traditionally requiring separate systems be brought together?
Can decentralised testing complement central laboratory services while extending access to diagnostics?
And could this help healthcare organisations design more flexible and efficient pathways around the needs of patients?
Haval summarises the potential of this new generation of technology powerfully:
“This is truly a game-changing innovation, both for the NHS and, most importantly, for the patients it serves.”
For Hadjer, the opportunity ultimately comes back to how innovation can support the evolution of patient care:
“The real value of diagnostic innovation is not simply what the technology can do. It is what that capability can enable within healthcare. If we can provide high-quality diagnostic information in the right setting, supported by the right governance and connected to the wider patient pathway, we have an opportunity to make diagnostics more accessible, more responsive and ultimately more valuable to both healthcare professionals and patients.”
The future of point-of-care testing may therefore be about much more than getting the same result more quickly.
It could be about reconsidering where diagnostics happens, how it connects with care and how advanced diagnostic information can be made available where it has the greatest impact: closer to the patient.
Explore the potential of multi-disciplinary POCT
The Ehome EHBT-50 MiniLab brings together 7-part differential haematology, biochemistry and immunoassays within a single compact platform.
Could it have a role within your diagnostic service or patient pathways?
Talk to the BHR Biosynex point-of-care diagnostics team to explore the technology, available assays and potential applications.
The Ehome EHBT-50 MiniLab is intended for professional healthcare use. Product and assay availability and regulatory status should be confirmed before use. Testing should be performed by appropriately trained personnel in accordance with the manufacturer's instructions for use and applicable clinical governance and quality requirements.
