POCTandLaboratoryMedicineAccreditation.ppt

POCT and Laboratory Medicine/Accreditation POCT and Lab Medicine Arun K. Garg PhD, MD, FRCPC Medical Director, Lab Medicine/Pathology Fraser Health/RCH 330 E. Columbia Street New Westminster, BC V3L 3W7 arun.garg@fraserhealth.ca 604-520-4330 Pathophysiology of disease has been foundation for diagnosis/management/ prognosis of disease and maintenance of health. Patient physician relationship is based on bedside medicine. “Lab” medicine has been integral to science of this relationship Delivery of lab medicine is a continuum from bedside to ward to central lab to bedside. Forces Changing Lab Medicine Point of Care Testing Point of Care Testing Others Home testing – Patient Self Remote Testing – Robotics Home Care Testing – Physician Office Testing Institutional Acute Care Traditional Lab Services – ER, ICU, OR, Wards, Ambulance Physician office Ambulatory clinics Community clinics Pharmacies Long-term/Extended Care Home Care Ambulance Some examples: Forces of POCT Diagnosis of disease in acute care Management of disease in chronic care Acute Care and POCT Flow and productivity in acute care and POCT Impact in ER/ICU/Critical Care area. Comparative cost of POCT v/s central testing. Limited success in acute care due to cost, complexity of medical decision process; broad scope of testing. Potential in bedside diagnosis of infectious diseases including infectious agents. Diagnosis in rural and isolated setting. Drugs of abuse Chronic Care and POCT Positive impact on management of diseases such as Diabetes; anticoagulation. Potential in therapeutic drug monitoring. Management of chronic diseases such as renal disease, other endocrine disorders. Improved outcome and quality of care, but no decrease in “budget requirement”. Patient self care and management. Technology and POCT Fastest growing area of lab medicine Merger of molecular biology, information technology, biomedical engineering Research and development cost Challenges of POCT Economic sustainability Relevan