Australia is by no means backward in embracing POCT technology. Glucose meters have been widely available for many years, hospitals and accredited pathology laboratories have also been using a wide range of POC devices for a considerable time. With the possible exception of glucose, hospital based POCT is usually related to emergency or critical care testing and is often performed in association with an accredited pathology service if Medicare reimbursement is to be sought. POC networks such as QAAMS, iCCnet and the Pathology Queensland POCT network are well established. These networks use documented quality control procedures and participate in external proficiency testing programmes.
In addition, diagnostic companies supplying glucose meters to hospitals provide quality control materials and a specifically designed EQA program with support to hospital wards in the use these quality indicators. Even though this support is available, participation is generally nota specific requirement and so is often sporadic.
Payment for most types of POCT is available through Medicare, provided such testing is undertaken by an accredited pathology service (laboratory). To be accredited, the laboratory must comply with AS 4633 / ISO 15189 or for specific POCT applications ISO 22870. A review of the Evolution of point-of-care testing in Australia is provided by Tirimaco.106
Often overlooked but also very common in Australia, is the use of POCT in sports medicine and workplace screening for drugs of abuse. Certainly from a legal perspective, POCT drug (and ethanol) testing is usually only considered as a preliminary or screening procedure. Positive screening tests for drugs of abuse usually require confirmation by an accredited laboratory based on Australian standard AS 4308.107