The Journal of mHealth Vol 1 Issue 3 (June 2014) - Page 43

Lab Quality Testing in the Palm of Your Hand Lab Quality Testing in the Palm of Your Hand New portable, mobile, point-of-care handheld testing devices, that can undertake a wide range of advanced laboratory procedures, have the potential to radically change care processes, by providing rapid pre-hospital, bedside and at-home diagnostic testing. Laboratory testing for accurate disease diagnosis is an essential and extremely effective everyday facet in the provision of medical care, however, traditional laboratory facilities are not always suited to every care situation. Often the time taken between the extraction of a sample at the point-of-care and the return of conclusive results can delay diagnosis and in turn impede the required treatment. Whilst laboratory testing is taken for granted in parts of the world, as a normal part of diagnostic care, in many regions there simply isn't the technology or infrastructure in place to allow sophisticated and sometimes even basic laboratory testing. From a patient's perspective the ability to relocate the testing environment from the doctors surgery or hospital to their home is a promising development that can significantly change the way in which a medical condition is monitored and treated. Basic bedside laboratory tests are nothing new, however, a new breed of portable devices are starting to deliver the opportunity for advanced testing procedures to be undertaken directly at the point-of-care with results being placed instantly in the hands of the attending physician. The possibilities of this type of technology spell cogent changes to the manner and particularly the rate at which diagnostic tests can be undertaken, and subsequent treatment prescribed. It also provides opportunities to conduct tests, that would previously have only been undertaken in a hospital or traditional care environment, remotely, wherever, and whenever they are required. plished through the use of transportable, portable, and handheld instruments (e.g., blood glucose meter, nerve conduction study device). The goal of these devices is to collect the specimen, test, and obtain test results rapidly at or near the location of the patient so that the treatment plan can be adjusted as necessary. Smaller, easier to use, faster, smarter, and connected devices are increasing the use of point-of-care-testing because it is now cost-effective for diagnosis and management of many diseases, such as diabetes, carpal tunnel syndrome, and acute coronary syndrome, while with the patient.[1] In diabetes care, continuous glucose monitoring systems are in routine use. These subcutaneous devices monitor glucose in real time and communicate with an insulin pump wirelessly. Insulin dose is then adjusted based on pre-programmed patient specific algorithms. These devices also enable seamless, real-time capture of patient data not only for immediate patient assessment and treatment but also for data collation, analysis, and evaluation to determine new approaches to improving patient safety (reduction in medical errors) and improved patient outcomes. A number of examples of this type of device are currently in advanced stages of development, and as a result we are beginning to see a growing number of different technologies available across a wide range of disease and condition types. All of these devices deliver rapid results using mobile technology to capture, store and relay disease specific information. By coupling the testing device with smartphone applications, it also means that manufacturers are able to reduce costs to deliver complex, yet affordable, solutions. Providing a patient with quantitative information, through selftesting and enabling this information to be shared with both care stakeholders, and software applications that can analyse the results, means that the user is given an increased role in the management of their own condition. The mobile aspect then provides connectivity to allow the transfer and sharing of this information with care providers, doctors, specialists, as well as enabling data capture in electronic medical records and other condition management solutions. Many lab-on-a -chip (LOAC) and nano-technologies are in the feasibility stages of development, and these devices use a variety of analytical methods for measurement of a specific analyte such as a routine chemistry, biomarker (protein or peptide), DNA/RNA, or a pathogen. Point-of-care-testing is accom- UK manufacturer QuantuMDx is one company at the forefront of handheld laboratory testing devices. They have developed a molecular diagnostic platform called Q-POCâ„¢, which is capable of extracting DNA from a variety of biological samples, and analysing them for specific disease characteristics. The universal device is a small handheld unit that can fit into a lab coat pocket. It incorporates an intuitive graphical user interface operated by a touchscreen and accepts cartridges that contain all the reagents and sensors required to process a whole sample such as blood, tissue (fresh and FFPE), thinned sputum, swabs, etc and to provide a molecular diagnosis in 10-15 minutes. Continued on page 42 The Journal of mHealth 41