The pandemic accelerated changes to how clinicians deliver care and how patients are comfortable receiving it. These shifts were a long time coming in an industry that can be slow to change when left to its own devices. One of those changes was the normalization and spread of point-of-care (POC) testing.
“Better tests at the point of care, better care up front, better empiric treatment, less antibiotic over-prescribing, less existential crises that our children are going to have to stare down like antimicrobial drug resistance…These are the types of innovations that can create a virtuous cycle: address problems in the near term but also mitigate and de-risk the likelihood of bigger issues arising down the road.” – Vin Gupta, MD
Vin Gupta, MD, a critical care pulmonologist, health technology executive and affiliate professor at the University of Washington’s Institute for Health Metrics and Evaluation, served as a medical consultant of a professional football team and shared that success story on a recent webinar.
He also detailed why use of POC testing will continue to grow post-pandemic and how it ultimately has the potential to democratize access to diagnostics previously available only at in-patient settings
Dr. Gupta outlined three key trends contributing to the continued rise of POC testing.
1. Healthcare is moving outside the hospital
As a result of the pandemic, people are now more comfortable accessing care outside of the traditional healthcare settings. Virtual visits rapidly have become the norm for many routine doctor visits as COVID-19 precautions kept people sheltered at home.
Data from the Centers for Medicare and Medicaid Services shows that, prior to the COVID-19 public health emergency, 15,000 Medicare beneficiaries received a telemedicine service each week . That number skyrocketed between mid-March and mid-October 2020 — in that seven-month period, more than 24.5 million beneficiaries and enrollees received telemedicine services.
Even beyond virtual doctor visits, patients are more routinely trusting over-the-counter digital tools and remote monitoring devices that help keep them healthy without going to physically see their physician.
It is now normal for patients to receive care outside of traditional settings, and POC testing fits within those expectations.
2. Payers are incentivizing “test to treat”
Health insurers are betting that investing in new technology to keep members healthy will lead to large savings downstream. For instance, many health plans offer members discounts on wearable devices and fitness trackers. When members use these tools to engage in their well-being, it can help keep them from developing costly chronic conditions later in life.
Similarly, with “test to treat,” when patients receive an earlier, accurate diagnosis, they can get treated more quickly and possibly stay out of the hospital. For instance, a Paxlovid trial showed the antiviral, when administered within five days of symptom onset, significantly reduced the proportion of patients who went to the hospital for or died from COVID-19 by 88% .
Commercial and government payers recognize they can achieve downstream savings when their members avoid costly hospitalizations or intensive treatments necessitated by worsening symptoms. In other words, paying for POC testing can achieve a higher return on investment for health plans.
3. Patients are acting as informed consumers
High-deductible health plans spurred patients to act more like consumers, taking responsibility for managing — and paying for — their healthcare choices. Patients are now scrutinizing their care choices to find the most convenient, affordable options available.
Additionally, individual health awareness is on the rise as a direct result of the pandemic. People are focused on staying healthy and are comfortable taking steps, either at home or in tandem with their care team, to do so.
Combined, this has led to the current revolution in diagnostics outside of the hospital. People can do more things on their own or under medical supervision to get and stay well. People are now used to swabbing themselves or receiving care from clinician other than a doctor and in a setting other than a hospital — and are in fact more willing to do so, because that type of care tends to be more convenient and affordable.
The future potential of point-of-care testing
Dr. Gupta asserted that while POC testing ingrained itself into the healthcare system as a direct result of the pandemic, its possibilities reach well beyond the novel coronavirus. The revolution of testing patients outside of the hospital and laboratory setting, combined with cutting-edge research and development, will lead to a new era where POC testing can be used for everything from strep throat to sexually transmitted diseases.
Currently, clinicians make an empirical diagnosis when a patient presents with an upper respiratory infection. They may prescribe antibiotics while awaiting lab results from a swab.
Researchers are working to change that by developing POC tests such as a rapid Pro-calcitonin that can distinguish if an infection is caused by a virus or a bacterium. If a test can tell the provider — at the point of care — if an infection is viral or bacterial, they can make a more accurate diagnosis and limit the unnecessary use of antibiotics.
Ultimately, point-of-care testing is trusted, clinical ready, and here to stay.
To hear more from Dr. Gupta on how to streamline the POC testing process and overcome challenges associated with its implementation, watch “The Impact of Upper Respiratory infection Testing at the POC: Speed, Outcomes, and Costs” webinar on demand.
The Accula SARS-CoV-2 Test brings rapid RT-PCR COVID-19 testing to the point of care
Used with a palm-sized, portable Thermo Fisher Scientific Accula Dock that plugs into a standard power outlet, the fully automated Thermo Fisher Scientific Accula SARS-CoV-2 Test provides RT-PCR testing in a small footprint without the need for a specialized lab. The test provides in an easy-to-read visual result in approximately 30 minutes while the patient waits. Sensitivity is comparable to lab-based RT-PCR tests . With its convenience and sensitivity, physicians' offices, pharmacies, urgent care clinics, and hospitals are turning to rapid RT-PCR testing for COVID-19.
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Disclaimer: The Accula SARS-CoV-2 Test has not been FDA cleared or approved but has been authorized for emergency use by FDA for use by laboratories certified under the Clinical Laboratory Improvement Amendments (CLIA) of 1988, 42 U.S.C. §263a, that meet requirements to perform high, moderate, or waived complexity tests. The test is authorized for use at the Point of Care (POC), i.e., in patient care settings operating under a CLIA Certificate of Waiver, Certificate of Compliance, or Certificate of Accreditation. This test has been authorized only for the detection of nucleic acid from SARS-CoV-2, not for any other viruses or pathogens. The emergency use of this test is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. § 360bbb-3(b)(1), unless the declaration is terminated, or authorization is revoked sooner.The performance of this test was established based on the evaluation of a limited number of clinical specimens. Clinical performance has not been established with all circulating variants but is anticipated to be reflective of the prevalent variants in circulation at the time and location of the clinical evaluation. Performance at the time of testing may vary depending on the variants circulating, including newly emerging strains of SARS-CoV-2 and their prevalence, which change over time.
Regulatory and Intended Use:For Use under the Emergency Use Authorization (EUA) Only.
For prescription use only. For in vitro diagnostic use.