The Oxford Academic Health Science Network (AHSN) has recently published a study exploring the use of point-of-care (PoC) testing within a busy GP group practice in the United Kingdom, using HORIBA Medical’s novel Microsemi CRP PoC haematology analyser.
This follows local Clinical Commissioning Group (CCG) demands to reduce unnecessary hospital visits and admissions due to winter flu.
The study shows that there are tangible benefits for urgent care clinical decision-making and cost savings by using this PoC technology in primary care. The current pressures on health services due to COVID-19 also add to the relevance of the findings.
The Brookside Group Practice (Lower Earley, Berkshire) had previously introduced a new patient pathway model by creating a multidisciplinary, paramedic-led urgent care clinic, aiming to retain patients in a primary care setting where possible. Already the subject of an in-depth audit and evaluation working alongside the AHSN, the practice’s urgent care model was shown to deliver reduced waiting times, more efficient referrals, and cost savings of between 4% to 38%.
The introduction of pathology PoC testing represented the second phase of the project to further enhance their decision-making process. Previous studies have also highlighted the benefits of using Microsemi CRP PoC test which is why this device was selected for use at the Brookside urgent care unit.
The Microsemi CRP requires just 18 μL of whole blood to deliver the simultaneous measurement of full blood count (FBC), including three-part differential, and C-Reactive Protein (CRP) within four minutes. The combination of CRP, an inflammatory marker, and white blood count plus granulocyte count, helps to identify sepsis, distinguish between bacterial and viral infection and also establishes the severity of disease. To offer a full suite of PoC test measurements, this analyser was placed alongside the i-STAT Alinity (Abbott) which detects blood chemistry abnormalities.
Following training, the analysers were operated by a variety of clinical staff: GPs, nursing staff and paramedics, demonstrating the ease with which the instrumentation can be operated. The study confirmed that the introduction of PoC testing at the GP practice fully supported the clinical decision-making process for a range of urgent care needs. It increased clinical confidence in diagnosis within the urgent care clinic leading to more appropriate patient referrals to secondary care. Indicative modelling on the costs of testing and secondary care referrals against instances where referrals were avoided established potential cost savings of more than £26,000 (about US$36,800) annually.
Feedback from healthcare professionals involved in the study also confirmed that the availability of a PoC test result allowed them to have a more meaningful or specific discussion with the patient about their diagnosis. Furthermore, patients tended to accept a test result more readily than the clinical opinion of the medical professional alone. As such the PoC testing also served to improve patient experience.
The Microsemi CRP analyser has been installed across a variety of primary and secondary care settings, including community hubs, emergency departments and assessment units where it is operated by multidisciplinary healthcare teams. In addition, CRP testing has been demonstrated to be a useful indicator of severity for COVID-19 patients alongside the more general application of the instrument’s parameters in patient triage.
Commenting on the study, Cleve Wright, Director, HORIBA Medical UK, said: “The current COVID-19 pandemic has provided a catalyst to explore different models for delivering care efficiently. This and studies like the one produced by Oxford AHSN have the potential to help shape the future of primary care. Our Microsemi CRP has been shown to be an invaluable PoC testing tool to support clinical decision making for urgent care pathways in primary care settings.”
Introducing point of care (POC) testing in a primary care urgent care pathway to improve clinical service delivery. www.oxfordahsn.org/wp-content/uploads/2020/11/Use-of-POC-testing-in-a-GP-Urgent-Care-Pathway-Report-Final-22-10-20.pdf
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