Point-of-Care Testing (POCT)
The need for doctors and other healthcare workers continues to increase with the increasing prevalence of ageing and chronic diseases in the general population. On the other hand, there is a shortage of physicians resulting from an insufficient number of graduating doctors and attrition. According to the Association of American Medical Colleges, there will be a shortage of more than 90,000 doctors in the United States alone by 2020. This creates an opportunity for the use of point-of-care testing (POCT) to alleviate some of the strain caused by physician shortage.
POCT is defined by 4 criteria:
Specimens are assayed at or near the patient.
Test results will be available within a short time frame.
Immediate diagnosis and/or clinical interventions can be implemented.
Results can be transmitted wirelessly and remotely to electronic health databases for further analyses.
The medical advantages of POCT can be significant. More frequent decentralized testing, reduction in clinical laboratory test numbers thereby decreasing wait times; higher standard of care for patients in rural areas where medical centers are distant; and greater patient engagement, are some examples.
Breast cancer is the leading cancer for females with 23,800 new cases, 26% of all new female cases, in Canada in 2013. A woman's lifetime probability of developing breast cancer is 11.5%.
Currently, the standard of care for breast cancer patient management is:
- Regular evaluation with history and physical examinations.
- Annual mammography starting from 1 year after diagnosis but no earlier than 6 months after adjuvant therapy.
This is a subject of debate in which guidelines are expert opinion-based. Early detection of relapse with biomarkers in asymptomatic patients can save both patient lives and healthcare costs.
Mobile Health (mHealth)
Mobile health (mHealth) refers to the use of mobile devices, such as smartphones, to support medical and health initiatives. With advances in lab-on-a-chip technology, smartphones are now used as diagnostic tools around the world.
The rationale for smartphone integration is simple. Smartphones have high penetration in the general population; the global average for smartphone ownership is 42%, and the Canadian average is 57% in 2014. Moreover, smartphones are equipped with most of the components required for a biosensor and at affordable prices as well. Furthermore, they have transmission capability as well as GPS technology to monitor disease epidemiology if necessary.
Some examples of the use of smartphones as diagnostic tools include malaria, asthma, thyroid disorders, dermatology and ophthalmology, among others.