Understanding Healthcare Professionals' Perspectives on Point-of-Care Testing

Advancing Point-of-Care Testing by Application of Machine Learning Techniques and Artificial Intelligence

The promise of artificial intelligence has generated enthusiasm among patients, health care professionals, and technology developers who seek to leverage its potential to enhance the diagnosis and management of an increasing number of chronic and acute conditions. Point-of-care testing increases access to care because it enables care outside of traditional medical settings. Collaboration among developers, clinicians, and end users is an effective best practice for solving clinical problems. A common set of clearly defined terms that are easily understood by research teams is a valuable tool that fosters these collaborations.

Implementation of a Self-Audit Tool Improves Regulatory Compliance for Point-of-Care Respiratory Virus Testing in the Emergency Department

BACKGROUND

Point-of-care testing in the emergency department decreases wait times and supports evidence-based patient care. However, hurdles to successful implementation include management of interdisciplinary work flows and establishment of an effective quality control program. As COVID-19 testing is now integrated into screening protocols in emergency and urgent care settings, hospital systems must maintain flexible and adaptable respiratory virus testing to adapt to regional trends in transmission. In response to this challenge, our hospital system established a point-of-care respiratory virus laboratory within the emergency department to test for COVID, influenza A/B, and respiratory syncytial virus (RSV). However, maintaining regulatory compliance and standardized protocols within such a dynamic environment became challenging.

METHODS

We launched a quality improvement initiative to support improved performance and efficiency in the point-of-care laboratory with a focus on regulatory benchmarks. Following a period of observation and discussion with key stakeholders in the emergency department and pathology, an audit tool was developed and to be deployed in collaboration with ED nursing. Utilizing the new tool, ED nursing would perform audits in parallel to audits performed by point-of-care staff.

RESULTS

Prior to the intervention, the average audit score was approximately 55%; 6 months following the intervention, audit scores have remained stable at approximately 80%, representing a significant improvement in regulatory compliance.

CONCLUSIONS

Creation of a regulatory tool enabled real-time cross-departmental monitoring of regulatory compliance. These findings underscore the importance of developing transparent interdisciplinary work flows and effective communication to improve patient care.

Point-of-care testing preferences 2020-2022: Trends over the years

Background

The use of point-of-care (POC) tests prior to the COVID-19 pandemic was relatively infrequent outside of the health care context. Little is known about how public opinions regarding POC tests have changed during the pandemic.

Methods

We redeployed a validated survey to uncompensated volunteers to assess preferences for point-of-care testing (POCT) benefits and concerns between June and September 2022. We received a total of 292 completed surveys. Linear regression analysis was used to compare differences in survey average response scores (ARSs) from 2020 to 2022.

Results

Respondent ARSs indicated agreement for all 16 POCT benefits in 2022. Of 14 POCT concerns, there were only 2 statements that respondents agreed with most frequently, which were that "Insurance might not cover the costs of the POC test" (ARS 0.9, ± 1.0) and "POC tests might not provide a definitive result" (ARS 0.1, ± 1.0). Additionally, when comparing survey responses from 2020 to 2022, we observed 8 significant trends for POCT harms and benefits.

Conclusion

The public's opinion on POC tests has become more favorable over time. However, concerns regarding the affordability and reliability of POCT results persist. We suggest that stakeholders address these concerns by developing accurate POC tests that continue to improve care and facilitate access to health care for all.

Leveraging COVID-era innovation for cervical cancer screening: Clinician awareness and attitudes toward self-sampling and rapid testing for HPV detection

Cervical cancer screening rates are declining in the US, with persistent disparities among vulnerable populations. Strategies to better reach under-screened communities are needed. The COVID pandemic sparked major shifts in healthcare delivery, including the accelerated development and adoption of rapid diagnostic testing, broadened access to remote care, and growing consumer demand for self-testing, which could be leveraged for cervical cancer. Rapid tests for the detection of Human Papillomavirus (HPV) have the potential to improve cervical cancer screening coverage, and if coupled with patient-collected cervicovaginal samples, create an opportunity for self-testing. The objectives of this study were: 1) to examine whether COVID influenced clinician perspectives of rapid testing as a screening modality; and 2) to assess clinician awareness, perceived benefits and limitations, and willingness to adopt point-of-care HPV testing, patient self-sampling, and rapid HPV self-testing with self-collected samples. The methodology adopted consisted of an online cross-sectional survey (n = 224) and in-depth interviews (n = 20) were conducted with clinicians who perform cervical cancer screening in Indiana, ranked in the top ten states for cervical cancer mortality and with marked disparities across socio-demographic groups. The main findings show that about half the clinicians reported that the COVID pandemic had influenced their views on rapid testing as a screening modality both positively (greater public acceptability of rapid testing and impact on patient care) and negatively (concerns regarding accuracy of rapid tests). The majority of clinicians (82%) were willing to adopt rapid HPV testing at the point-of-care, while only 48% were willing to adopt rapid HPV self-testing with self-collected samples. In-depth interviews revealed provider concerns around patients' ability to collect their own sample, report results correctly, and return to the clinic for follow-up and other preventive care. Addressing clinician concerns about self-sampling and rapid HPV testing, such as ensuring that rapid tests include sample adequacy controls, is necessary to mitigate barriers to adoption for cervical cancer screening.

COVID-19: a gray swan's impact on the adoption of novel medical technologies

The COVID-19 pandemic offers a unique context and opportunity to investigate changes in healthcare professional perceptions towards the adoption of novel medical technologies, such as point-of-care technologies (POCTs). POCTs are a nascent technology that has experienced rapid growth as a result of COVID-19 due to their ability to increase healthcare accessibility via near-patient delivery, including at-home. We surveyed healthcare professionals before and during COVID-19 to explore whether the pandemic altered their perceptions about the usefulness of POCTs. Our network analysis method provided a structure for understanding this changing phenomenon. We uncovered that POCTs are not only useful for diagnosing COVID-19, but healthcare professionals also perceive them as increasingly important for diagnosing other diseases, such as cardiovascular, endocrine, respiratory, and metabolic diseases. Healthcare professionals also viewed POCTs as facilitating the humanization of epidemiology by improving disease management/monitoring and strengthening the clinician-patient relationship. As the accuracy and integration of these technologies into mainstream healthcare delivery improves, hurdles to their adoption dissipate, thereby encouraging healthcare professionals to rely upon them more frequently to diagnose, manage, and monitor diseases. The technological advances made in POCTs during COVID-19, combined with shifting positive perceptions of their utility by healthcare professionals, may better prepare us for the next pandemic.