Point of care testing in a large urban academic medical center: Evolving test menu and clinical applications

IntroductionThere have been many reports describing individual POCT technologies but there are no recent studies describing the organizational scope and impact of a POCT program.MethodsOur menu of POCT tests has increased to 26 and the test volume to 664,287 tests/year equivalent to 14.5% of the volume of the central core laboratory. POCT is performed in nearly all inpatient units and in a variety of outpatient settings.ResultsCumulatively 84.6% of the test volume and most testing sites can be accounted for by 4 traditional tests (bedside glucose testing, fecal occult blood, dipstick urinalysis and activated clotting time). Most POCT tests are not performed because of a true medical necessity but rather to improve the efficiency of clinical operations.ConclusionWe are experiencing a significant increase in requests for new POCT tests. Unlike established high volume conventional POC tests, these new requests originate from specialized services seeking to improve the efficiency of clinical operations.