Point-of-Care Technologies for the Future: Technological Innovations and Hurdles to Implementation

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Places for point-of-care testing (POCT) now include the home, pharmacy, supermarket, physician's office, and the hospital bedside. Expansion of the quantity and scope of POCT may depend on several factors. This paper discusses how government health care policy and regulations, availability of POCT, views of the general public, and cost of testing will influence POCT; how new technologies that make POCT easier, more reliable, and more likely to be accepted and how broader developments in Web-based electronic health records will contribute to the scope of POCT. Retail health clinics offer a new source of POCT for the public, but this type of health care resource has met with opposition from the medical establishment (eg, American Medical Association). Sending specimens directly to a laboratory represents another route to a diverse series of tests, including genetic tests and large panels of tests for "wellness" and nutritional status. An important factor in the future of POCT is the technological innovation that makes it easier, more reliable, and hence, more likely to be accepted. Such developments provide a possible and significant stimulus to POCT. Innovations are being drawn from a number of areas including the consumer electronics industry and from developments in Wi-Fi and graphical interfaces. Other sources include spin-offs from bio-warfare testing (chemical agent monitors and integrated polymerase chain reaction devices) and the $1000 genome project. In addition, new developments in microtechnology, such as lab-on-a-chip-type devices, and nanotechnology present possible solutions to the analytical and logistical challenges posed by POCT. Predicting the future of POCT is difficult, but the scope of current options and technological solutions would seem to point to the further expansion and diversification of this form of testing.

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