Coagulation monitoring devices: Past, present, and future at the point of care

• History of coagulation testing and automation in the hematology laboratory.
• Transition from central laboratory testing to point-of-care (POC) devices.
• Recent progress in the development of POC coagulation monitoring technologies.
• The future potential of coagulation POC devices in clinical diagnostics.

Automated technologies have revolutionised the monitoring of coagulation disorders in the central hospital laboratory setting, allowing for high throughput testing, improved accuracy and precision, accompanied by a marked reduction in human error. However, they still require trained operators and sample transportation. With the advent of point of care (POC) testing, the working principle of traditional coagulometers was used as the foundation for the development of miniaturised devices. A number of POC coagulation devices have been commercially available for many years now, allowing the patient to assume more control over the management of their own medication, e.g. warfarin. While POC devices for measuring anticoagulation have relied principally on clotting time tests, novel platelet function tests, and factor-specific assays based on enzymatic or immunoassay principles are becoming available, driven by the emergence of new anticoagulant drugs, in addition to the inability of clotting tests to accurately detect many thrombotic disorders. This review highlights recent progress in the development of POC coagulation monitoring technologies and examines their future potential in clinical diagnostics.