This is why we can’t have nice things
Feb. 20th, 2026 08:08 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
walkitoutI’ve been struck by how the structure of primary care is likely to stymie the wide deployment of POCT. Doctors offices and clinics that engage in appointment - prescription or test order - appointment will be in no hurry to lengthen appointments (they are already scheduling every 15 minutes) and add cost by doing the test themselves and then extend the appointment post-test to assess and take further action (possibly including more testing lather rinse repeat). Central labs are likely to resist the loss of the (majority of?) their business to POCT tests, and will engage in shenanigans to “prove” that POCT tests are not good enough. Administrators won’t want to change anything because that’s just more work for them.
There are a few places in the US system where the structure is enough different that POCT might take off. Kaiser Permanente’s all-in-house structure means they are less inclined to push costs off onto someone else. And indeed, they implemented an Afiona based hba1c POCT in the covid era because it helped get the least controlled diabetics under improved control. Of course, the era of Ozempic and cheap “narcs” arrived so …
I also thought to look to Canada, as their NHS might, like KP, be less inclined to push costs off onto someone else. However, their understanding of the range of tests available and their quality suggests whoever wrote their framework document is operating off of out of date information, and they are mostly focused on using POCT to get out into underserved areas. And they don’t even understand the difficulty of head to head comparison of POCT to central lab (POCT is tiny amounts of whole blood, central lab is larger quantities of centrifuged fractions).
I’ll be back later.
There are a few places in the US system where the structure is enough different that POCT might take off. Kaiser Permanente’s all-in-house structure means they are less inclined to push costs off onto someone else. And indeed, they implemented an Afiona based hba1c POCT in the covid era because it helped get the least controlled diabetics under improved control. Of course, the era of Ozempic and cheap “narcs” arrived so …
I also thought to look to Canada, as their NHS might, like KP, be less inclined to push costs off onto someone else. However, their understanding of the range of tests available and their quality suggests whoever wrote their framework document is operating off of out of date information, and they are mostly focused on using POCT to get out into underserved areas. And they don’t even understand the difficulty of head to head comparison of POCT to central lab (POCT is tiny amounts of whole blood, central lab is larger quantities of centrifuged fractions).
I’ll be back later.