Toward Sustainable Point-of-Care Testing in Remote Australia–the Northern Territory i-STAT Point-of-Care Testing Program

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Abstract
Since 2008 in Australia, the Northern Territory (NT) department of health has been in partnership with the Community Point-of-Care Services unit (now the Flinders University International Centre for Point-of-Care Testing) to deliver quality-assured point-of-care testing on the i-STAT device (Abbott Point of Care, Doncaster, Australia) for the provision of selected pathology services in 33 of its remote health centers in the Territory. A set of agreed research outcomes were developed jointly to assess and validate the operational and clinical effectiveness as well as the analytical safety of point-of-care (POC) testing in remote NT health centers. Across the first 4 years of the program, more than 500 health professional staff have been trained as qualified POC testing operators, and more than 21,250 patient tests on the i-STAT have been performed. Analytical quality for POC testing has met profession-based analytical goals and/or state-of-the-art laboratory performance for most tests. Clinical case studies sourced from the i-STAT central data station (which electronically captured deidentified patient and quality data from all remote services) has confirmed the clinical effectiveness of POC testing for acute and chronic conditions. Community satisfaction with POC testing was validated using qualitative surveys of device operators. Greater than 80% of respondents believed POC testing was more convenient than the laboratory and assisted in the stabilization of patients with acute illness. The Northern Territory i-STAT Point-of-Care Testing Program has therefore proven operationally effective, analytically sound, clinically and culturally effective, and has been well-received by health professional staff.

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