Is the COVID-19 pandemic a positive side? A recent article by UMass Chan Medical School and UMass Lowell researchers at Communications in the humanities and social sciencesa nature wallet Journal, reports that interest among healthcare professionals in point-of-care technologies (POCTs) has increased during the pandemic, with envisioned applications for devices that are easy to use at home, mobile, or bedside in a wide variety of diseases.
Healthcare professionals have also viewed the adoption of point-of-care testing as facilitating the humanization of epidemiology—in other words, sharing control and management of disease diagnosis with patients, rather than continuing to be provider driven.
The authors write that so-called “grey swan events,” predictable but unpredictable, can change attitudes and behaviors, such as how communities are managed and provide access to health care, as well as provide unique opportunities to spur innovation. COVID-19 presented one opportunity from this gray swan.
“I was trying to understand if there was any kind of positive trajectory that occurred as a result of COVID,” said senior author Dennis R. Dunlap, PhD, associate professor of global strategy, entrepreneurship and innovation at UMass Lowell’s Manning School of Business. “Fortunately, we collected the data before COVID hit. And then, we ran another survey that was going on during that time period in the pandemic. So, it provided a unique opportunity to study trends before and after COVID.”
Relatively few other studies have looked at factors that influence the adoption of point-of-care testing among health care professionals, according to the paper’s authors. COVID-19 has provided an opportunity to highlight weaknesses in healthcare delivery systems, including reliance on laboratory-based diagnostic technologies, and to rapidly develop new technologies to meet patients’ needs.
Dr. Dunlap and colleagues worked with UMass Chan researchers David D. McManus, MD, The Richard M. Heydak Professor of Medicine Chair and Professor of Medicine. Nathaniel Haver, PhD, Assistant Professor of Molecular Medicine and Senior Investigator at the National Institute of Health (NIH) Rapid Acceleration of Diagnostics (RADx) Core Logistics Team for Technical Clinical Studies; Craig M. Lilly, Professor of Medicine, Anesthesia, and Surgery; Fourth year medical student TH Chan Chun Tibaji.
“The point of care was really stagnant for a long time,” Dr. Haver said. “Now, after experiencing COVID, everyone knows what home testing is and the benefits of being able to test themselves. So, the conversation has changed from, ‘What is this all about?’ to, ‘How do we apply this now to cancer or other infectious diseases, etc. that?”
In the current study, researchers conducted matched surveys of a network of healthcare professionals, researchers, and medical device developers. The first survey was distributed from October 2019 to late March 2020. The second survey was distributed from late October until November 2020.
Respondents were asked to name up to five conditions that point-of-care testing could help diagnose; Name up to five conditions in which point-of-care testing can help them monitor or manage disease; And what characteristics of point-of-care tests are most important when incorporated into their usual practice.
Prior to the COVID-19 pandemic, health care professionals identified 18 categories of medical conditions in which point-of-care testing could be used to diagnose disease. Endocrine disorders, including diabetes mellitus, featured prominently among these disorders, followed by infectious diseases, cardiovascular diseases, and blood diseases.
After classifying COVID-19 as a pandemic, healthcare professionals have identified 20 medical conditions that can be used in point-of-care testing to diagnose the disease. Infectious diseases and medical conditions related to the heart and blood vessels rose to the center of this network, followed by endocrine, respiratory and hematological diseases.
Perceptions of point-of-care testing for managing or monitoring a disease have also changed. Prior to the pandemic, healthcare professionals defined cardiovascular disease as the category in which point-of-care technology was most useful for monitoring or management. Once COVID-19 was classified as a pandemic, endocrinology was identified as the most useful condition in point-of-care testing. However, metabolic diseases have seen the greatest increase in interest.
“I think there are many different reasons why point-of-care technology has become more important after COVID; the more you get used to using technology, the more you see the benefits of having that technology,” Dunlap said.
Dunlap suggested that during the pandemic, many people were not diagnosed with cardiovascular disease or cancer because they were afraid to go to the hospital or their health care provider canceled routine checkups.
“Covid has made it so, not only were point-of-care testing necessary for COVID testing, but point-of-care technologies were needed as health care became more decentralized,” said Dr. McManus. “There is no question from our paper that you can see the changes in terms of acceptance of these technologies and integration into mainstream healthcare. People thought they were add-ons, but that is an essential component of healthcare now.”
The project was developed by the UMass Center for Advances in Point-of-Care Technologies (CAPCaT), a member of the NIH Point-of-Care Technology Research Network, and co-directed by McManus and co-author Bryan Buchholz, PhD, chair and professor of biomedical engineering at UMass Lowell. Supported by a $7.9 million grant from the National Institutes of Health, CAPCaT is part of the Massachusetts Medical Device Development Center (M2D2), run by UMass Chan School of Medicine and UMass Lowell, to help biotech and medical device startups bridge the gap between the idea And the market.