CONGRESS 2023 - Supporting Point-of-Care Testing in Virtual Wards: What are the challenges and how do we overcome them?

A variety of virtual ward services are delivered across Oxfordshire through collaboration of Oxford University Hospitals NHS Foundation Trust, Oxford Health NHS Foundation Trust, and Principal Medical Ltd (PML) a GP led service. They include Hospital at Home, Children’s Virtual Ward (jointly with OHFT), Acute & Community Palliative/End of Life Care (Community – Sue Ryder Care). The Point of Care Testing (PoCT) team at Oxford University Hospitals NHS Trust has supported the development and delivery of PoCT in community and ambulatory settings over the past 10 years. Using a model developed around the requirements of ambulatory medicine; this has been delivered with limited resource, focussing on utilising existing resources wherever possible. Commencing with the Acute Hospital at Home, the service has been successfully expanded to support mobile PoCT across Oxfordshire. The laboratory acts as the distributor of instruments and supplies; facilitates connectivity, and testing, and coordinates delivery of training through a combination of remote and cascade routes. Device selection and repertoire has been standardised. Up to this point mobile services have been limited to use of the Abbott i-Stat & Alinity systems (electrolytes/metabolites/blood gas). However, Hospital at Home, and other mobile services are requesting a greater repertoire of tests, particularly CRP. The LumiraDx platform provides us with an option for CRP that is portable, easy to operate, connectable and robust. Challenges remain around connectivity and information management. This has been exacerbated by the cross-organisational nature of these services leading to the management of patients through multiple IT systems; and led to the development of indirect routes for result entry into the patient record. Whilst we have been able to deliver connectivity in two rapid response vehicles, this was not a scalable solution and mobile devices are docked at the base location on return from visits.

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