Article Abstract

Routine molecular point-of-care testing for respiratory viruses in adults presenting to hospital with acute respiratory illness

Authors: John P. Hays

Abstract

The implementation of infectious disease Point-of-Care (ID-POCT) diagnostics into the clinical environment lags behind the implementation of Point-of-Care diagnostics in other fields of medicine, especially in the field of clinical chemistry, where for example blood pressure and blood sugar POCT diagnostics are relatively common (1,2). In fact, the problems associated with the implementation of ID-POCT are numerous and currently include among others: a lack of reimbursement of costs by insurers, incomplete acceptance by physicians of the actual value of ID-POCT, and issues related to introducing ID-POCT into existing infectious disease clinical diagnostic work practices, e.g., coupling ID-POCT to existing laboratory information management systems, the establishment of new quality control and quality assurance schemes, training staff to perform non-routine manipulations, introducing new reporting procedures, etc.) (3-6). Additionally, although many existing and new ID-POCT devices are (becoming) available for clinicians to use, many of these have been/are being developed with a focus on adapting current state-of-the-art technologies to the medical environment, instead of focusing on the actual clinical need and then developing/adapting technologies to meet these actual needs (in terms of costs, ease-of-use, time-to-result, etc.). Performing research into the effect of ID-POCT, by for example measuring the impact of the use of ID-POCT in the clinical environment using parameters such as reduction in unnecessary antibiotic prescribing, shortening the length of hospital stay and rationalizing the use of isolation facilities, is one way of providing tangible evidence of the advantages, or disadvantages, of implementing ID-POCT into clinical environments. A recent study by Brendish et al. provides more evidence for the debate surrounding the implementation of ID-POCT into emergency departments and acute medical units (7,8).

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