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Chapter 23 : Management of Point-of-Care Testing
In this chapter, the management challenges of point-of-care testing (POCT) are categorized into organizational, operational, and technological issues, although some of the issues listed in reality overlap into more than one category. The chapter concentrates on aspects of the management of POCT that differ from other areas of the laboratory and that are controversial. One of the most critical operational challenges is deciding what sites will perform POCT and what menu of tests should be offered. The major source of demand for POCT has been from clinicians who desire rapid laboratory results for clinical decision making. There are a number of other complicating factors about cost analysis, the most important being that of weighing the indirect effects of POCT on the overall cost of patient care. The major argument against use of electronic simulators is that although they check performance of the electronic components of an analyzer, they do not check the performance of the reagents. Procedures that are performed by devices attached to patients such as those involved in the analysis of breath specimens were considered to represent physiological monitoring rather than laboratory testing.