Abstract
Objectives: (a) To understand how to integrate geospatial concepts when implementing point-of-care testing (POCT); (b) to facilitate emergency, outbreak, and disaster preparedness and emergency management in healthcare small-world networks; (c) to enhance community resilience by using POCT in tandem with geographic information systems (GISs) and other geospatial tools; and (d) to advance crisis standards of care at points of need, adaptable and scalable for public health practice in limited-resource countries and other global settings.Content: Visual logistics help integrate and synthesize POCT and geospatial concepts. The resulting geospatial solutions presented here comprise: (1) small-world networks and regional topography; (2) space-time transformation, hubs, and asset mapping; (3) spatial and geospatial care paths™; (4) GIS-POCT; (5) isolation laboratories, diagnostics isolators, and mobile laboratories for highly infectious diseases; (6) alternate care facilities; (7) roaming POCT—airborne, ambulances, space, and wearables; (8) connected and wireless POCT outside hospitals; (9) unmanned aerial vehicles; (10) geospatial practice—demographic care unit resource scoring, geographic risk assessment, and national POCT policy and guidelines; (11) the hybrid laboratory; and (12) point-of-careology.Value: Small-world networks and their connectivity facilitate efficient and effective placement of POCT for optimal response, rescue, diagnosis, and treatment. Spatial care paths™ speed transport from primary encounters to referral centers bypassing topographic bottlenecks, process gaps, and time-consuming interruptions. Regional GISs position POCT close to where patients live to facilitate rapid triage, decrease therapeutic turnaround time, and conserve economic resources. Geospatial care paths™ encompass demographic and population access features. Timeliness creates value during acute illness, complex crises, and unexpected disasters. Isolation laboratories equipped with POCT help stop outbreaks and safely support critically ill patients with highly infectious diseases. POCT-enabled spatial grids can map sentinel cases and establish geographic limits of epidemics for ring vaccination.Impact: Geospatial solutions generate inherently optimal and logical placement of POCT conceptually, physically, and temporally as a means to improve crisis response and spatial resilience. If public health professionals, geospatial scientists, and POCT specialists join forces, new collaborative teamwork can create faster response and higher impact during disasters, complex crises, outbreaks, and epidemics, as well as more efficient primary, urgent, and emergency community care.
Highlights
RationaleSynthesis of geospatial and POC concepts can facilitate emergency care, crisis response, and control of highly infectious diseases, such as Ebola virus disease (“Ebola”)
We present visual logistics from geographic information system (GIS) analyses in the Eyre Peninsula, Australia; Pernambuco State, Brazil; Palawan Island, Philippines; Hualien County, Taiwan; and Nan Province, Thailand
Hospital directors stated that 80% of their community population should be diagnosed and ideally, treated, in primary care sites outside the hospital, in order to prevent saturation of emergency rooms that cannot handle huge numbers of patients and unexpected surges that show up for evaluation
Summary
Synthesis of geospatial and POC concepts can facilitate emergency care, crisis response, and control of highly infectious diseases, such as Ebola virus disease (“Ebola”). Integration of both concepts improves population access to healthcare. Point-of-care testing is defined as diagnostic testing at or near the site of patient care [78, 79] It is inherently spatial, that is, performed at or near points of need, and intrinsically temporal, because it produces fast actionable results. That is, performed at or near points of need, and intrinsically temporal, because it produces fast actionable results This definition does not depend on the size or format of the handheld, portable, or transportable instrument, test module, or assay design.
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