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Table 2 Summary of the facilitators and barriers to use of point of care tests (POCT) in family medicine clinics

From: Exploring the barriers and facilitators to use of point of care tests in family medicine clinics in the United States

Themes Facilitators Barriers
1. Impact on clinical decision-making - Faster decision-making
- Earlier triaging of possible serious illness
- Improved confidence in treatment decisions (e.g. antibiotics)
- Immediate results not helpful in some situations (e.g., monitoring of chronic conditions)
- Over-reliance undermining physician clinical skills
- Increase in unnecessary testing
2. Accuracy concerns - Improved ‘rule out’ value when used with clinical features - Less accurate than laboratory tests
- Positive test results often misleading
3. Impact of POCT on staff and clinic workflow - Reduced clinic difficulties with patient follow-up for laboratory tests between office visits
- More POCT may alleviate pressure on under-staffed laboratories
- Concerns increased testing volume may extend patient visits/overwhelm providers
- Insufficient healthcare personnel within clinics to manage additional testing
- Risk of error in reporting results for tests without EMR interface
4. Impact on perceived patient experience and patient-physician relationship - Improved patient-provider communication
- Patient awareness of work involved in making a diagnosis, making providers feel more valued
- Improved patient understanding and acceptance of provider treatment decisions (e.g., antibiotics)
- Perceived greater acceptability of fingerstick blood testing by patients and clinic
 
5. Influence of cost, regulation and quality control   - Perceived expense compared to laboratory tests
- Uncertainty about reimbursement rates from insurers and loss of clinic revenue
- Lack of laboratory trust in giving clinics responsibility for quality control processes
- Lack of clinic autonomy to adopt new tests