Point-of-Care Testing – A Quick Win Damned by EBM

The decision by our Department of Health not to fund point-of-care testing is a perfect example of how healthcare is stunted by regulation and our concern for evidence in a world evolving faster than we can think – let alone publish systematic reviews.

Point-of-care (PoC) laboratory testing has numerous advantages over the traditional large-scale laboratory systems. The obvious ones  are timeliness and accessibility. According to numerous studies it is cost-effective, and most of those were extremely limited studies that only assessed the actual cost’s of testing – not time saved or travel saved etc. In effect, they were completely distorted studies in terms of cost-effectiveness.

In Australia, where GP’s in remote areas often have to wait 3 days for an INR before adjusting a Warfarin dose, it seems illogical that we can’t give themPoC testing.

It’s detractors suggest GP’s might over-test (as if that doesn’t happen already). I would suggest that the very demands of organising the test in-house, while quick and easy, is still harder than ticking a box and would give GP’s and patients a better sense of the usefulness of their tests.

The last time PoC testing was evaluated by the government was apparently 1997. If they wait another 12 years before the next review I predict we’ll have the ability to buy kits off the internet for home use by then. Only because the government will pay for us to have a doctor do will patients not test themselves.

Yet again, the limitations of bureaucracy and the limitations of trying to evidence-base breakneck speed and complexity means a loss for consumers of health.