Pathology in your pocket: Point of care testing in rural and remote settings
Urban healthcare providers are fortunate with access to the latest and greatest point of care devices and technologies. For those operating in a rural and remote setting however, it is a completely different story.
That is what Cameron Martin and his team at Queensland Health discovered many moons ago when they began the mammoth task of implementing a system to support remote and rural medicine with point-of-care technology in Queensland.
Mr Martin is the State-Wide Point of Care Testing Coordinator at Queensland Health. It was his vision to ensure the people of Queensland were given seamless delivery of pathology. Irrespective of their geographical location.
Speaking about the project Mr Martin said; ‘We extended pathology services to areas of Queensland where there were virtually none before. Changing the face of healthcare delivery for those living in rural and remote locations forever.
It is safe to say that point-of-care testing is the saving grace for rural and remote healthcare professionals and patients alike. The Queensland Health pathology system facilitates the best of the laboratory to remote testing areas. Enabling healthcare providers to get the best possible readings and results on their patients. So they can have the confidence to make an informed decision at the point of care.’
Queensland Health now operate some form of point-of-care installation across the 1.85Km2 area and claim to have the largest point-of-care network in the world. The team are constantly on the lookout to expand and include more testing capabilities in their system.
Chief Executive Officer of Pathology Technology Australia, Dean Whiting said;
“Despite the outstanding efforts to roll out point-of-care testing in Queensland, Australia is about ten years behind comparable economies in our adoption of this important testing technology. We could leverage the great work at Queensland Health, and in other state health departments, to establish a national point-of-care testing policy, framework and funding to provide equity in healthcare for all Australians.”
The current Queensland Health system includes the type of tests that provide accurate results. The results allow healthcare providers to make a decision for patient treatment on site. Or to refer them to a larger facility.
The current tests available through Queensland Health for those in rural and remote areas include: Blood Gases, Electrolytes, Lactate, Troponin 1, BNP, B HCG, Prothrombin Time/INR, Creatinine, Glucose, HBA1c, CRP/Chole/Trigs, Urine testing and WCC/Diff. Essentially creating a pathology lab in the pocket of rural and remote clinicians.
Fast and reliable
The state-wide software currently in place automatically runs test results through the middleware. This is where analysers are managed, to the LIS, Auslab. Ten minutes later a clinician in a larger facility will be reviewing the sample. The objective is end-to-end communication of medical notes. This means tests do not need to be repeated unnecessarily and paperwork doesn’t go missing.
Speaking about the system Mr Martin said, ‘The idea is for smaller centres in remote areas to have the ability to refer patients to larger facilities with clear and reliable evidence. Enabling healthcare providers to make decisions about their patients on site rather than relying on tests performed at a large facility at a later date.
Which means better patient outcomes because advice can be given in real time. This removes the need for the patient to travel long distances unnecessarily. It’s not all perfect of course. The urine testing for example will require a more comprehensive follow-up test. However, it will at least point a rural and remote General Practitioner in the right direction to begin with.’