Point-of-Care Testing Collected Works

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    Economic evaluation of point-of-care testing in the remote primary health care setting of Australia’s Northern Territory
    (Dove Press, 2018-05-29) Spaeth, Brooke ; Kaambwa, Billingsley ; Shephard, Mark Douglas ; Omond, Rodney
    Aim: To determine the cost-effectiveness of utilizing point-of-care testing (POCT) on the Abbott i-STAT device as a support tool to aid decisions regarding the emergency medical retrievals of patients at remote health centers in the Northern Territory (NT) of Australia. Methods: A decision analytic simulation model–based economic evaluation was conducted using data from patients presenting with three common acute conditions (chest pain, chronic renal failure due to missed dialysis session(s), and acute diarrhea) at six remote NT health centers from July to December 2015. The specific outcomes measured in this study were the number of unnecessary emergency medical retrieval prevented through POCT. Cost savings through prevented unnecessary medical retrievals for each presentation type were then determined and extrapolated to give per annum NT-wide estimates. Results: POCT prevented 60 unnecessary medical evacuations from a total of 200 patient cases meeting the selection criteria (48/147 for chest pain, 10/28 for missed dialysis, and 2/25 for acute diarrhea). The associated cost savings were AUD $4,674, $8,034, and $786 per patient translating to NT-wide savings of AUD $13.72 million, $6.45 million, and $1.57 million per annum (AUD $21.75 million in total) for chest pain, missed dialysis, and acute diarrhea presentations, respectively. Conclusion: This study demonstrated that POCT when used to aid decision making for acutely ill patients delivered significant cost savings for the NT health care system by preventing unnecessary emergency medical retrievals.
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    How to set up and manage a point-of-care testing service
    (Australasian Association of Clinical Biochemists, 2004) Shephard, Mark Douglas
    In this paper, various point-of-care testing (POCT) models for early detection and/or management of chronic diseases in rural Aboriginal communities are used to provide practical examples of how to set up and manage a viable and sustainable point-of-care testing (POCT) service, whether it be in a general medical practice (GP) clinic, Aboriginal health service, or hospital service or clinic.
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    Point-of-care testing in the Indigenous rural community
    (Australasian Association of Clinical Biochemists, 2004) Shephard, Mark Douglas
    This paper describes three health programs - the 'Umoona Kidney Project', the national 'QAAMS' Program for point-of-care HbA1c testing and the 'Point-of-Care in Aboriginal Hands' Program. The common feature these models share is the use of point-of-care technology for the early detection and/or management of chronic diseases (renal disease, diabetes and cardiovascular disease). The primary focus of each program has been the rural and remote Aboriginal Community Controlled Health Service (ACCHS) sector, because these three chronic diseases account for a huge burden of morbidity and mortality in Aboriginal Australians.
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    The national QAAMS Program - a practical example of PoCT working in the community
    (Australasian Association of Clinical Biochemists, 2010) Shephard, Mark Douglas ; Gill, Janice P
    The Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS) Program is the largest and longest-standing national point-of-care testing (PoCT) program in Australia. With a focus on PoCT for diabetes management, it now operates in 115 Indigenous medical services and has been funded continuously by the Australian Government for 11 years. A recent independent evaluation of the QAAMS Program concluded the program continues to meet best practice standards for Indigenous healthcare, diabetes management and PoCT.
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    The conduct of quality control and quality assurance testing for PoCT outside the laboratory
    (Australasian Association of Clinical Biochemists, 2010) Gill, Janice P ; Shephard, Mark Douglas
    Within pathology laboratories, quality assessment, internal quality control (QC) and external quality assurance (EQA) are integral components of a laboratory’s quality system. They are tools to ensure that the quality of results being produced by laboratory testing will not compromise the clinical care of the patient. This criterion applies equally when the testing environment changes from the laboratory to the point of care, and the large laboratory instrument becomes a smaller device.
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    Point-of-care testing and creatinine measurement
    (Australasian Association of Clinical Biochemists, 2011) Shephard, Mark Douglas
    This paper reviews the current status of point-of-care testing (PoCT) devices that are available for measuring whole blood or serum/plasma creatinine globally and within Australasia. Information on non-analytical specifications and analytical performance is provided using data sourced from recently published literature, external quality assurance programs and evaluative work by the author’s unit. The limitations of current devices are summarised.