Abstract
Background/Approach: In 2020, the Aboriginal and Torres Strait Islander COVID-19 Point-of-Care (PoC) testing program delivered training, quality management and governance for rapid PCR testing at ~100 Australian remote and regional health services, with testing conducted by health service staff. We describe a novel, positive alert system which aimed to ensure result quality and facilitate immediate public health action.
Analysis/Argument:
POC program co-ordinators liaised with jurisdictional public health stakeholders and health services regularly to understand proposed, immediate public health response plans for COVID-19 outbreak/s. In response, jurisdictional/regional specific processes for identifying, verifying, and reporting positive results (ie. the positive alert system) were developed, and included instructional resources for health services, a 24/7 phone support for positive result verification (hotline) and technical troubleshooting. Operators were advised to call the hotline after each positive result, and an electronic connectivity system was established to alert positive results. Hotline staff recorded relevant patient clinical and epidemiological information, verified analytical quality, and reported results to stakeholders. Weak SARS-CoV-2 results (cycle thresholds >35) were investigated by repeat PoC testing, additional negative controls, and testing on alternative laboratory platforms where required.
Outcome/Results: Between March 2020-August 2022, 4307 positive results were verified. Of these, 26% (1122) had high Ct values which required further investigation. The median time from start of test to receipt of notification by relevant stakeholders (including test run time of ~45 minutes) was 99 minutes.
Conclusions/Applications: Decentralised PoC testing networks require support systems to verify the analytical quality of results and rapidly communicate the results. To our knowledge the development of the positive result alert system in primary care is novel; with other decentralised POC programs generally providing technical support. These processes are critical in an emergency response setting and where timely, accurate results are required for appropriate clinical management.
Analysis/Argument:
POC program co-ordinators liaised with jurisdictional public health stakeholders and health services regularly to understand proposed, immediate public health response plans for COVID-19 outbreak/s. In response, jurisdictional/regional specific processes for identifying, verifying, and reporting positive results (ie. the positive alert system) were developed, and included instructional resources for health services, a 24/7 phone support for positive result verification (hotline) and technical troubleshooting. Operators were advised to call the hotline after each positive result, and an electronic connectivity system was established to alert positive results. Hotline staff recorded relevant patient clinical and epidemiological information, verified analytical quality, and reported results to stakeholders. Weak SARS-CoV-2 results (cycle thresholds >35) were investigated by repeat PoC testing, additional negative controls, and testing on alternative laboratory platforms where required.
Outcome/Results: Between March 2020-August 2022, 4307 positive results were verified. Of these, 26% (1122) had high Ct values which required further investigation. The median time from start of test to receipt of notification by relevant stakeholders (including test run time of ~45 minutes) was 99 minutes.
Conclusions/Applications: Decentralised PoC testing networks require support systems to verify the analytical quality of results and rapidly communicate the results. To our knowledge the development of the positive result alert system in primary care is novel; with other decentralised POC programs generally providing technical support. These processes are critical in an emergency response setting and where timely, accurate results are required for appropriate clinical management.
| Original language | English |
|---|---|
| Publication status | Published - 14 Mar 2023 |
| Event | Australasian Conference on Point of Care Testing for Infectious Diseases - Sheraton Grand Sydney Hyde Park, Sydney, Australia Duration: 14 Mar 2023 → 15 Mar 2023 Conference number: 1st https://www.kirby.unsw.edu.au/events/poc23-1st-australasian-conference-point-care-testing-infectious-disease (Conference link) |
Conference
| Conference | Australasian Conference on Point of Care Testing for Infectious Diseases |
|---|---|
| Abbreviated title | POC23 |
| Country/Territory | Australia |
| City | Sydney |
| Period | 14/03/23 → 15/03/23 |
| Other | To accelerate access to new point-of-care technology, we need research in all these areas to provide the most effective implementation pathways. To respond to this evolving challenge, ASHM and the RAPID Point of Care Research Consortium for infectious disease in the Asia Pacific made the decision to run this two-day conference. The conference will collaborate with leading scientists, clinicians, and other stakeholders to develop a program on the ever-evolving landscape of point-of-care testing for infectious diseases and provide time to discuss challenges and solutions to scaling up point-of-care testing in this setting. |
| Internet address |
Keywords
- SARS-Cov-2
- Point of care testing
- positive
- notification
