Faster treatment thanks to point-of-care diagnostics – in emergencies and beyond

Making an informed and immediate treatment decision near or at the patient’s bedside – point-of-care testing (also known as POCT) makes this possible. Unlike stationary devices, special exam rooms or other service infrastructure, POC diagnostic devices offer a multitude of benefits including more flexibility, faster results, and lower costs - be it in emergency medicine, in hospitals or in doctor's offices.

POC testing is primarily used in diagnostic imaging and laboratory medicine. Not all applications at the patient’s bedside are automatically POC applications: While an ultrasound machine or other medical imaging modalities are a common sight in many medical offices, portable medical devices in hospital rooms or in emergency medicine are also gaining popularity. That being said, few doctor's offices have their own in-house laboratory, which means they must send their patient samples to an outside laboratory service provider for analysis. But we are also seeing an increasing number of testing devices and rapid tests physicians use in their office to diagnose specific conditions.

The greatest advantage of POC tests is a faster diagnosis, which leads to a faster treatment of the patient. "When blood samples are collected at the doctor's office today, patients must wait up to three or four days to get the results," explains Jürgen Neumann, President of LRE Medical GmbH in an interview with MEDICA-tradefair.com. "Yet if the doctor uses POC diagnostic devices, the result might be available in less than two hours."

Time is of the essence in emergency medicine. Rapid clinical decision making can make all the difference. Portable diagnostic devices for biomarker detection are just one example: "This currently includes identifying patients with a suspected heart attack or performing a blood gas analysis. Some modern tools can deliver results in less than fifteen minutes, whereas hospital laboratories have turnaround times of three to four hours," explains Neumann. Speed is also a key advantage in hospitals when intensive care units utilize these types of test devices.

Portable imaging such as point-of-care ultrasound (POCUS) is another great tool in medical emergencies – though there is one caveat: While a POC test processes a patient sample automatically, a POCUS exam takes time during which the patient must not move. That is why an emergency physician must decide "whether its application may contribute to delays since onsite ultrasound may waste precious time or whether it is particularly relevant to the treatment of the patient," says Dr. Achim Ehrt from the Medical Center Ingolstadt in a MEDICA-tradefair.com interview.

POC tests also play a key role in the ongoing coronavirus pandemic as it relates to infection protection and control for first responders and hospital patients. Modern test equipment can perform PCR testing for COVID-19 and other pathogens, and deliver results within a few hours without the need for a stationary laboratory. While rapid tests are faster than PCR tests, the latter are more accurate and reliable when properly performed by a health care professional. This gives staff a greater sense of security and makes it possible to take appropriate precautions and safety measures when it comes to emergency admissions.

In the future, point-of-care tests will reach more and more patients owing to their speed, flexibility, and cost-effectiveness. "More and more manufacturers offer compact, portable devices. In the not-too-distant future – let's say within five to ten years – anesthesiologists will probably no longer wear a stethoscope around their necks but carry a small transducer, because it can provide far more information and facilitate differently types of exams," Ehrt predicts. 

Major health care providers like hospitals can only benefit from acquiring POC diagnostic devices. There is no need to set up parallel structures when large imaging devices, laboratories and POC devices are working in tandem. They complement each other and can be used for different testing purposes that previously required the same equipment and facilities in all cases.

For general practitioners, POC is synonymous with service and allowing patients to receive earlier treatment if specialized laboratory tests can be performed right at the medical office. Both patient and doctor get faster test results, which eliminates extensive wait times and prolonged patient suffering.

The coronavirus pandemic revealed yet another benefit of point of care diagnostic devices: Some countries have relaxed COVID restrictions and continue to do so as vaccinations pick up pace and new virus cases decrease. This reopening is also made possible by rapid COVID tests, which are meant to make visits to events and restaurants easier and safer. Jürgen Neumann highlights the key role POC diagnostic devices can play in this setting: "If a rapid test result is positive, you could take a PCR test using POC testing platforms within an hour. This could lead to an emergence of new business models."