Point-of-care tests: rapid diagnosis in emergency situations

In emergency medicine, a faster diagnosis leads to a faster treatment of the patient. Point-of-care test solutions can provide immediate on-site insights into the patient’s condition. COVID-19 adds another dimension: the devices can provide a level of security and safety – one that goes beyond intensive care.

In this MEDICA-tradefair.com interview, Jürgen Neumann from LRE Medical talks about the possible applications of point-of-care test devices and explains how they could evolve in the future and might find their way into medical practices.

Mr. Neumann, how important are point-of-care diagnostic devices in the emergency department?

Jürgen Neumann: Their importance keeps growing. Point-of-care (POC) refers to medical diagnostic testing at or near the patient. An emergency physician obviously does not have access to a big laboratory on-site like he would at a hospital. POC testing in this setting provides faster results than a laboratory analysis. It offers benefits that extend beyond the clinical aspect and include organizational and ultimately economic advantages, because it allows the physician to respond immediately to patient conditions.

In which situations are POC diagnostic devices used?

Neumann: They are beneficial in situations in which accurate and rapid results are needed to facilitate faster and more efficient processes to provide quality patient care. 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. Armed with this knowledge, the emergency physician can start the initial treatment much sooner.

What is important when it comes to POC test development?

Neumann: In emergency care settings, devices must be robust, user-friendly, and intuitive and provide reliable, accurate and clearly displayed results, which offer rapid safety and security.

Complex biochemical processes take place inside the device as is the case when you test for infectious diseases such as hepatitis or COVID-19. The patient sample must be processed accurately to ensure a reliable analysis: mixing the sample with a reagent, heating and cooling of the reaction liquid, optical read out, processing and displaying via software. All this must be done safely and accurately in the short, allotted time. It also makes the design of these solutions very complex.

This is precisely the talent and expertise we offer our customers: we incorporate all these technical facets to make the smallest possible device that provides the most accurate test results. Today everyone would give anything to have a PCR test in their pocket. The technology is coming, but it is not quite there yet.

Did you see an increased demand for your solutions amid the COVID-19 pandemic?

Neumann: We did, but more in terms of a pull-forward effect. We did not develop our solutions specifically with SARS-CoV-2 in mind. We designed them to identify different viral or bacterial pathogen combinations, which includes the coronavirus.

Since the beginning of the pandemic, our systems have facilitated a flexible increase of PCR testing capacity. They were used at airports to set up on-site test centers, for example. Needless to say, this demand shift has had a positive impact on our company.

Has the coronavirus pandemic also spurred innovations?

Neumann: Definitely. There are the mobile testing centers and the fact that POC diagnostic devices have provided access to new customer segments in tourism and the event industry. And I think this trend is far from over, especially when you think of events that will not allow access without a rapid coronavirus test. 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.

What other trends do you see for applications of POC testing?

Neumann: I think we are witnessing a powerful mind shift. All physicians could have these types of devices in their practice in five years. This will also drive further innovation: Today's tools offer complex solutions that cover a broad spectrum. It means we might see derivatives that focus only on specific issues and will subsequently be less expensive.

If we look at standard healthcare, fast turnaround times give POC an edge: when blood samples are collected at the doctor's office today, patients must wait up to three or four days to get the results because the analysis is performed by an outside laboratory. Yet if the doctor uses POC diagnostic devices, the result might be available in less than two hours. This drastically decreases wait times and avoids prolonged patient suffering.

Flexibility is another important aspect. The current pandemic has shone a bright light on this. Once places such as airports, hotels or movie theaters are reopening, they will be very flexible thanks to mobile point-of-care diagnostics devices. Before 2020, who would have thought that we would have test centers in these venues? Nobody! But this also shows how perceptions are changing and new needs are emerging in this unprecedented setting.