Point of Care Testing: Best Practice Toolkit for Improving Access to Point of Care Testing in Mobile Medicine

Abstract

Practice Problem: Healthcare for persons experiencing homelessness (PEH) is a complex issue. Chronic and communicable diseases are disproportionately represented within this population. Healthcare spending is 2.5 times more costly in comparison to those who have not experienced homelessness. Although mobile health clinics aim to reduce the concerns with access to care, they do not eliminate barriers if the appropriate tests are not immediately available. PICO: In the homeless population treated in mobile medicine (P), what is the effect of point of care testing (I) on turnaround time (O) compared with outside laboratory testing (C)? Evidence: Critical analysis of the literature revealed that point of care testing (POCT) is equivalent to or better at improving test results from baseline, improving medication adherence, and cost effectiveness. In PEH, this can significantly reduce the average days to treatment. Intervention: Using the CDC’s Program Evaluation Framework, three established mobile health clinics were evaluated to determine if the mobile environment was an appropriate setting to support POCT tools. Ultimately, it was determined that there was a need for an environment-specific toolkit to support additional POCT tools in mobile healthcare. Outcome: A POCT in mobile medicine toolkit was created to support implementation of additional tools, which can provide rapid and convenient access to testing, results and treatment in a population known to have difficulty accessing traditional healthcare services. Conclusion: This toolkit is designed to improve the multi-layered and complex issue of healthcare for the intended population. This is driven by the need to enhance the quality of care, patient outcomes, and operational efficiency of mobile healthcare.