Optimizing Global Resiliency in Public Health, Emergency Response, and Disaster Medicine.

Abstract

Resiliency through use of point-of-care (POC) testing in small-world networks will change the future landscape by bringing evidence-based decision-making to sites of need globally. This issue of Point of Care addresses fundamental principles and essential building blocks that mitigate crises and enhance standards of care. Several papers on needs assessment support the case for onsite testing in different medical situations. Then, the focus shifts to how to protect POC devices and reagents from extremes of temperature and humidity that are encountered virtually anywhere POC testing is used outside hospitals. Indeed, the effects of environmental stresses can no longer be ignored. We have observed the advent of the "hybrid laboratory" where POC whole-blood analysis is performed using transportable instruments in non-laboratory settings and the rapid expansion of portable and handheld testing now found ubiquitously worldwide. Emerging new POC technologies will propel personalized medicine by targeting treatment. Trendy as these advances are, in low-resource settings POC instruments often represent the default armamentarium of the small community hospital. Hence, education and competency become essential prerequisites for creating, maintaining, harmonizing, and standardizing accuracy and quality as new cost-effective technologies become available. Excellent performance brings value, which is one of the keys to this next phase in the history of point of care. By increasing the value of decision-making at the site of care, we can assure resiliency, for the individual patient who might be in need of self-monitoring, for rational responses to crises, and for nations made up of more resilient individual communities.