Dr Aparna Jairam, Founder and Director, Dr Aparna’s Pathology Laboratory, Mumbai, Centre of Excellence of Autoimmunity and, Infertility, Indore
Point of care testing (POCT) was once considered as a very nonpathology kind of testing in a laboratory. I am convinced that with more and more multinationals and Indian diagnostic companies coming forward with good sensitivity, specificity, and traceability the methodology is in for diagnostics. ISO 15189:2012’s new edition also mentions POCT in the standard and the QSP and SOP to be maintained for the tests done by POCT in the scope of the respective pathology laboratory, thus opening the era of POCT and accreditation.
POC tests are simple medical tests, however, till some time back simplicity was not achievable until technology developed and better kits with better traceability were available. POCT is widely used in blood sugar tests; hemoglobin estimation; PT/INR; glycohemoglobin; arterial blood gases; cardiac markers like CKMB, troponins, BNP; infection makers like procalcitonin, urine pregnancy tests; infectious disease markers for HIV, HBsAg, HCV, drugs of abuse in urine, fecal occult blood, lipid makers; and will include many more tests in the future. Rheumatology, hormonal, tumor markers are now picking up in the field of POCT.
Standard, rapidly widely used parameters can be used by POCT; these can be used for mass screening of population, for making rapid decisions particularly in casualties for cardiac emergencies, reducing the burden on the healthcare, easy reportability, and thus use of the professional skills in the best way. POCT is a boon also in Tier-II and Tier-III cities, where access to best diagnostic labs is very rare.
The challenge in POCT is lack of availability of kits with specificity and traceability. POCT is the best way forward for our country, where there are challenges for the skilled manpower in areas like Tier-II and Tier-III cities, and there also exists a challenge in immediate access to some critical parameters like troponin. POCT will reduce the unnecessary admission in hospital, screening of major healthcare disease, and monitoring of diabetes, blood pressure.