Integrating diagnostics into clinical care

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Integrating diagnostics into clinical care

Diagnostics laboratories for decades have been an indispensable aspect of the healthcare delivery system. Undoubtedly, the role of laboratories cannot be challenged in patient care, be it in diagnosis, treatment or monitoring patient’s health unambiguously. Studies have authenticated that up to 60% to 70% of therapeutic decisions are laboratory dependent.

However, delay in diagnosis at the primary care level is detrimental and comes at the cost of patient safety. Unfortunately, there is no data to map the adverse effects of this delayed diagnosis. Many global bodies are working towards evidence-based understanding about the causes of and ways to elucidate delay in diagnosis and other diagnostic errors. The inverse care law. i.e. the mismatch between patients medical requirements and the availability of healthcare resources has a significant impact on healthcare provider’s performance. Another reason for these diagnostic challenges is an atypical presentation of common ailments. However, often the delayed diagnosis is attributed to an individual and not considered as an organizational or system failure.

A third of patients visiting a primary care physician are advised laboratory investigations. Incorporating diagnostics into primary clinical care with means of high-end portable point of care devices that can be used in the clinic itself will aid in dealing with the so-called Diagnostics Desert – not just in remote geographies and underserved segments of society, but also in the context of paucity of time and commitment for follow up test procedures even in patients in an urban setting.

In clinicians view, the delayed diagnosis can be taken care by the mediation of time and cost effective measures. Integrating diagnostics at primary care aids numerous benefits like:

  • Rapid access to investigation results
  • Immediate clinical diagnosis facilitating initiation of appropriate treatment and intervention
  • Engaging the patient in the care process with relevant data
  • Lower sample volume as compared to that required in a regular diagnostic lab
  • Reduces pre-analytical errors

Timely diagnosis will thus prevent the deterioration of patient’s health thereby reducing the burden on the healthcare system. Though the prevailing situation in India is not very satisfying, the innovation of in-clinic diagnostic devices will certainly change the face of healthcare delivery system soon.

Ref:

  1. Bhatia R. Indian J Med Microbiology. 2018 Apr-Jun;36(2):153-154.
  2. Kazmierczak SC. Clin Chem. 2011 Sep;57(9):1219-20.
  3. Tudor Car L, et al. BMC Fam Pract. 2016 Sep 9;17:131.
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