Point-of-care testing – a reality to be dealt with

Report on a seminar on 19 November 2002
Arranged by the Swedish Association of Health Professionals and the Swedish Institute for Biomedical Laboratory Science (IBL)

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Pilot project for POCT in Sörmland

In Sörmland, the county council and Capio Diagnostik have agreed to develop POCT Sörmland. This was based on the county council’s vision that 80 per cent of analytical activity should become point-of-care within three years. Lars Lundgren is medical development manager for Capio Diagnostik AB.

The reason why project form was chosen was this vision (which is not, however, "practice" today), the condition to be met for procurement, the content of the contract, the fact that the process is faster and that work across organisational boundaries is facilitated. The steering group consists of the chief executive of the county council and the CEO and Deputy CEO of Capio Diagnostik.

One of the aims of POCT Sörmland is to bring about system integration, instead of the diversification that is driven forward by manufacturers, meaning that individual doctors obtain their own equipment.

The main working group for the project is working on defining ranges of tests for routine activities. There are six sub-projects for the following areas: IT, quality assurance, competence development, equipment, logistics and replacement models. The work in the sub-projects is to result in a system description, i.e. what instrumentation, IT, logistics, quality, training and also the economic aspect look like.

The system description is to lead to specified and (if possible) alternative solutions for point-of-care testing by using existing care staff for all analytical work and/or parts of it, while more complex analyses are performed by biomedical scientists.

The work is intended to provide a basis for implementation in five pilot units in primary care, somatic care and intensive care. They are healthcare centres in Strängnäs and Nyköping, the children’s clinic at Mälaren Hospital, accident and emergency at Kullbergska Hospital in Katrineholm and the medical clinic at Nyköping Hospital.

Agreement has been reached in the project on common names for analyses, but the equipment in the various pilot projects may differ.
There have been tough talks along the way both in the laboratory organisation and in the county council. The pilots start during the autumn of 2002 when the various elements have been ticked off and approved: instrumentation, IT - e-record, premises, training, quality and logistics. A reference measurement for key values is performed before the start.

POCT Sörmland is intended to lead to all referrals being sent electronically and all test results being held in the laboratory data system. The pilots are reporting regularly on development and an assessment is due to be made in September 2003, partly on the basis of questionnaires sent to biomedical scientists, doctors and administrative heads. A new measurement of key values will then also be made.

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