Central Laboratory Service and Point-of-Care Testing in Germany - From Conflicting Notions to Complementary Understandings

Point-of-care testing (POCT) enables health care personnel to perform laboratory medicine tests near the patient. The underlying technology and the range of test parameters available are evolving rapidly. Thus, a series of clinical applications are possible that can shorten the time for clinical decision-making about additional testing or therapy, as delays are no longer caused by preparation of clinical samples, transport, and central laboratory analysis. The idea of conventional and POCT laboratory services presiding within a hospital seems contradictory; yet, they are, in fact, complementary: together POCT and central laboratory are important for the optimal functioning of diagnostic processes. They complement each other, provided that a dedicated POCT coordination integrates the quality assurance of POCT into the overall quality management system of the central laboratory. We describe here the clinical, organizational, and economic issues of hospital POCT from the European point of view. The advantages of POCT are to be combined with the core competences of the central laboratory to significantly improve the overall patient outcome. This review also portrays novel developments for POCT due to the fact that future utilization of POCT globally will depend on health care trends and new areas of application.