Perspectives on the impact of point-of-care testing for cardiac markers on healthcare professional working relationships

Applications of point-of-care testing (POCT) for diagnostic biomarker measurement in healthcare have increased significantly in recent years in a wide range of clinical scenarios. These include infectious disease, critical care, cardiology and other areas of emergency medicine. Traditionally, routine clinical pathology investigations were performed by dedicated clinical biochemists and pathologists within a hospital-based central laboratory provision. As an alternative, POCT aims to improve key clinical outcomes by providing for a faster test turnaround time (TAT) facilitated by being deployed in the vicinity of the patient. In addition, it has been suggested that POCT can contribute to delivering health economic benefits by reducing admissions and hospital length-of-stay costs. Despite these potential benefits, however, POCT poses a considerable challenge in its operation outside the central laboratory. In particular, it can have a direct impact on healthcare professional working relationships; for example, clinical and nursing staff are commonly responsible for performing diagnostic tests rather than laboratory staff. At the same time, the widespread deployment of POCT will also generate new support roles for clinical biochemists and pathology staff in the regulation and quality assurance of POCT outside the central laboratory. In this article, perspectives on the likely future impact of cardiac-marker POCT on working relationships are discussed based on opinions provided in a survey of healthcare professionals.