The new Administration has made clear that a top priority will be to improve access to and the quality of healthcare in America.  Achieving these objectives will require challenging hurdles to be traversed, namely addressing the rising costs of new technologies, the lack of preventative care, and the escalating cost of prescription medications.  Effective and efficient administration of healthcare is essential for obvious reasons, among them the vibrancy of our economy and homeland security as evidenced by the recent outbreak of the H1N1 influenza. 

While the challenges of achieving the Administration’s goals are daunting, advancements in precision point-of-care (POC) diagnostic technology has begun to lay the pathway toward improving costs, quality, and access.  So what is a POC test?  Probably the most well-known is the home pregnancy test, which had a revolutionary effect on the health care system by giving almost immediate results, reducing unneeded doctor visits, and empowering personal care.  Until now, POC testing has taken a back seat to expensive and often unnecessary medications and other treatments as medicating patients as both a precaution and as a method of healthcare expedience has become the most efficient approach to treatment. 

But a new wave of POC development is underway, and this innovation is leading the effort to provide tools to clinicians to accurately and inexpensively diagnose patients for a range of viruses, thereby giving consumers more options in their care.   In certain infectious conditions, having an accurate diagnosis during the initial patient visit helps to limit the prescription of unnecessary antibiotics and reduces the spread of disease.  Limiting unnecessary antibiotics has been demonstrated to reduce healthcare costs by saving patients and insurance companies’ money, but also will help reduce the generation of superbugs and microbial resistance. 

These POC devices currently are being used for common conditions such as conjunctivitis – or pink eye – in which an in-office test can have an astounding impact on improving the management of the diseases.  For pink eye, the clinical ability to differentiate viral from bacterial conjunctivitis is often challenging.  Viral diseases, such as those caused by adenovirus (viruses that infect the tissue linings of the respiratory tract and eyes), are highly contagious, may lead to significant morbidity, and do not respond to antibiotics. Since adenoviruses are the most common ocular pathogen to cause conjunctivitis, misdiagnosis and empiric antibiotic treatment of all cases contributes to overuse of unnecessary antibiotics and increased spread of disease.  Furthermore, beyond the national health care costs associated with this management strategy, patients with a viral infection bear the personal expense of the unnecessary antibiotics and the false sense of non-contagiousness following the ineffectual treatment. 

The ongoing global outbreak of the “swine flu” (H1N1) demonstrates perfectly the critical need for POC tests to fill the gap in preparedness, which is the inability of the world, and more specifically the United States, to immediately identify  those infected with a disease.  Although vaccination is the current principal measure for preventing influenza and reducing the impact of potential epidemics, it is often challenging to develop a vaccine during the course of the concurrent flu season.  Constant genetic changes in influenza viruses mean that any vaccine must be adjusted annually to include the most recent circulating influenza.   

The policy of the United States has been to give preference to the deployment of pills and vaccines rather than inexpensive and accurate POC diagnostic tests that can quickly identify who needs the treatments and calm those who do not.  This point was made clear during recent Senate hearings on the pandemic when the leaders of the health and homeland security committees solicited testimony concerning the need for diagnostics to strengthen the preparedness of the United States in combating a biological threat like the current pandemic flu outbreak.

Precision POC tests are the future of healthcare and critical for U.S. preparedness.  A shift in emphasis in policy toward these devices not only will have a profound impact on the prevention of the spread of disease and minimize the consequences of the next global pandemic, but will dramatically reduce costs, improve quality of care, and provide more affordable access to care.