Development of a universal connectivity and data management system

We have reached single-visit testing, diagnosis, and treatment for hepatitis C infection, now what?

INTRODUCTION

Progress toward hepatitis C virus (HCV) elimination is impeded by low testing and treatment due to the current diagnostic pathway requiring multiple visits leading to loss to follow-up. Point-of-care testing technologies capable of detecting current HCV infection in one hour are a 'game-changer.' These tests enable diagnosis and treatment in a single visit, overcoming the barrier of multiple visits that frequently leads to loss to follow-up. Combining point-of-care HCV antibody and RNA tests should improve cost-effectiveness, patient/provider acceptability, and testing efficiency. However, implementing HCV point-of-care testing programs at scale requires multiple considerations.

AREAS COVERED

This commentary explores the need for point-of-care HCV tests, diagnostic strategies to improve HCV testing, key considerations for implementing point-of-care HCV testing programs, and remaining challenges for point-of-care testing (including operator training, quality management, connectivity and reporting systems, regulatory approval processes, and the need for more efficient tests).

EXPERT OPINION

It is exciting that single-visit testing, diagnosis, and treatment for HCV infection have been achieved. Innovations afforded through COVID-19 should facilitate the accelerated development of low-cost, rapid, and accurate tests to improve HCV testing. The next challenge will be to address barriers and facilitators for implementing point-of-care testing to deliver them at scale.

Advances in point-of-care genetic testing for personalized medicine applications

Breakthroughs within the fields of genomics and bioinformatics have enabled the identification of numerous genetic biomarkers that reflect an individual's disease susceptibility, disease progression, and therapy responsiveness. The personalized medicine paradigm capitalizes on these breakthroughs by utilizing an individual's genetic profile to guide treatment selection, dosing, and preventative care. However, integration of personalized medicine into routine clinical practice has been limited-in part-by a dearth of widely deployable, timely, and cost-effective genetic analysis tools. Fortunately, the last several decades have been characterized by tremendous progress with respect to the development of molecular point-of-care tests (POCTs). Advances in microfluidic technologies, accompanied by improvements and innovations in amplification methods, have opened new doors to health monitoring at the point-of-care. While many of these technologies were developed with rapid infectious disease diagnostics in mind, they are well-suited for deployment as genetic testing platforms for personalized medicine applications. In the coming years, we expect that these innovations in molecular POCT technology will play a critical role in enabling widespread adoption of personalized medicine methods. In this work, we review the current and emerging generations of point-of-care molecular testing platforms and assess their applicability toward accelerating the personalized medicine paradigm.

Evaluation of organizational variables of quality 4.0 in digital transformation: the study of an Indian manufacturing company

Purpose

The study aims to identify organizational variables of quality 4.0 for an Indian manufacturing company in the case of digital transformation. Furthermore, the organization enhances its quality 4.0 performances to its success based on the degree of relevance of these variables, insight into these variables and sub-factors to prioritize them.

Design/methodology/approach

Initially, two rounds of the survey were conducted with 11 decision-makers from the company made to receive organizational variables scores and prioritize the factors and sub-factors. Analytic Hierarchy Process (AHP) based research methodology has been proposed to assign the criterion weights and prioritize the identified variables.

Findings

The results of this AHP model demonstrate that “Committed Leadership” is recognized as the top positioned variable and most significant organizational variable, followed by Collaboration and Quality culture, which are developed at the next level. These essential organizational variables with their sub-categories' priorities are identified as contributing attributes.

Research limitations/implications

The findings facilitate quality 4.0 in the digitalization era, which take into contemplating the current state of the business. Furthermore, the understanding of variables provides insightful guidance to analyze, solve complex problems and assess the efficacy of quality 4.0 in digital transformation.

Originality/value

The novelty of this study is to pinpoint, and evaluate the responsible organizational variables and prioritize them that lead to high productivity and competitive advantage considering the AHP method.

Utilizing connectivity and data management system for effective quality management and regulatory compliance in point of care testing

Point of care testing (POCT) is one of the fastest growing disciplines in clinical laboratory medicine. POCT devices are widely used in both acute and chronic patient management in the hospital and primary physician office settings. As demands for POCT in various healthcare settings increase, managing the quality and regulatory compliance are continually challenging. Despite technological advances in applying automatic system checks and built-in quality control to prevent analytical and operator errors, poor planning for POCT connectivity and informatics can limit data accessibility and management efficiency which impedes the utilization of POCT to its full potential. This article will summarize how connectivity and data management system can improve timely access to POCT results, effective management of POCT programs, and ensure regulatory compliance.

Challenges of development and implementation of point of care pharmacogenetic testing

INTRODUCTION

Just as technology was the underlying driver of the sequencing of the human genome and subsequent generation of volumes of genome sequence data from healthy and affected individuals, animal, plant, and microbial species alike, so too will technology revolutionize diagnostic testing. One area of intense interest is the use of genetic data to inform decisions regarding drug selection and drug dosing, known as pharmacogenetic (PGx) testing, to improve likelihood of successful treatment outcomes with minimal risks.

AREAS COVERED

This commentary will provide an overview of implementation research of PGx testing, the benefits of point-of-care (POC) testing and overview of POC testing platforms, available PGx tests, and barriers and facilitators to the development and integration of POC-PGx testing into clinical settings. Sources include the published literature, and databases from the Centers for Medicaid and Medicare Services, Food and Drug Administration. Expert commentary: The utilization of POC PGx testing may enable more routine test use, but the development and implementation of such tests will face some barriers before personalized medicine is available to every patient. In particular, provider training, availability of clinical decision supports, and connectivity will be key areas to facilitate routine use.

The history of pathology informatics: A global perspective

Pathology informatics has evolved to varying levels around the world. The history of pathology informatics in different countries is a tale with many dimensions. At first glance, it is the familiar story of individuals solving problems that arise in their clinical practice to enhance efficiency, better manage (e.g., digitize) laboratory information, as well as exploit emerging information technologies. Under the surface, however, lie powerful resource, regulatory, and societal forces that helped shape our discipline into what it is today. In this monograph, for the first time in the history of our discipline, we collectively perform a global review of the field of pathology informatics. In doing so, we illustrate how general far-reaching trends such as the advent of computers, the Internet and digital imaging have affected pathology informatics in the world at large. Major drivers in the field included the need for pathologists to comply with national standards for health information technology and telepathology applications to meet the scarcity of pathology services and trained people in certain countries. Following trials by a multitude of investigators, not all of them successful, it is apparent that innovation alone did not assure the success of many informatics tools and solutions. Common, ongoing barriers to the widespread adoption of informatics devices include poor information technology infrastructure in undeveloped areas, the cost of technology, and regulatory issues. This review offers a deeper understanding of how pathology informatics historically developed and provides insights into what the promising future might hold.

Adopting a personal digital assistant system: application of Lewin's change theory

AIM

This paper reports a study exploring nurses' perceptions of adopting an information system using handheld computers (personal digital assistants) in their daily practice.

BACKGROUND

Handheld computers have recently been used in nursing information systems for patient care, but few studies have explored their impact on users. By understanding clinicians' experiences of using this technology, strategies can be implemented to smooth the change process in adopting their use, thus achieving optimal patient outcomes.

METHOD

A descriptive, exploratory approach was used to study nurses' perceptions of using personal digital assistants as part of a hospital information system. A purposive sample of 15 nurses participated in one-to-one, in-depth interviews from February to March 2004. Nurses' perceptions of the adoption process were analysed using Lewin's force field theory of change as a framework.

FINDINGS

Nurses initially resisted using the personal digital assistant system (unfreezing stage), then came around to using it (moving stage), and finally adopted the system in their daily practice (re-freezing stage). However, an anticipatory stage also occurred and this could serve as a feedback mechanism to improve the system for current and future use.

CONCLUSION

Educational programmes should be provided and strategic planning should be done in the early stage of implementing a policy to adopt new technology. In addition, the adoption process and learning period could be shortened by improving the system's content design. During this transition stage, dual charting should be used as a backup only for a limited time to avoid adding extra work to nurses' already heavy workload. Finally, the concept of confidentiality should be reinforced and stressed early in the educational programme to protect patient data, which can easily be accessed in computerized systems.