Global-of-care testing (GOCT): emerging challenges for laboratory medicine network.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has placed laboratory medicine at the forefront of public health and clinical care. Larger use of social media and official communication platforms raised public awareness of laboratory science, driving demand for rapid, accurate diagnostic information and shifting expectations around access and interpretation of testing. Laboratory medicine, rooted in accuracy, precision, reproducibility and clinical relevance, has advanced from basic diagnostics to sophisticated molecular and data-driven platforms. Yet, literature and policy on coordinated international laboratory networks, especially for surveillance and emergency response, remain limited. This opinion paper introduces the concept of "global-of-care testing", encompassing globally connected diagnostic infrastructures with regional adaptability, robust governance, and sustained investment in technology and workforce. Laboratory network design must account for geography and population density in allocating facilities. Integrated systems require automation capable of interfacing across multiple platforms (preanalytical processing, clinical chemistry, immunochemistry, hematology, coagulation, urinalysis and even molecular diagnostics and mass spectrometry) to optimize workflows, support real-time decision-making, facilitate remote collaboration and maintain rigorous quality assurance. A decentralized yet interconnected model allows peripheral laboratories to actively participate in clinical decision-making through shared protocols, telemedicine and integrated data, ultimately reducing turnaround times, improving responsiveness and enhancing patient-centred care. Embedding Value-Based Laboratory Medicine (VBLM) within this framework ensures that diagnostics are aligned with health outcomes in a multidisciplinary ecosystem organized around patient needs. The future of laboratory medicine will hence depend on evidence-based reforms that integrate technology, reorganize systems and reinforce governance for promoting quality, equitable access and sustainable precision healthcare.