Professor Shephard is director of the Flinders University International Centre for Point-of-Care Testing, a groundbreaking unit that is a global leader and advocate for point-of-care testing research, teaching and innovation. Since 1996, this team has taken pathology testing that was previously only available in laboratories and managed its use in primary care settings across Australia and internationally.
Molecular point-of-care testing has proved invaluable in diagnosis of COVID-19 throughout remote Australia. Embedding successful elements for remote point-of-care testing of diabetes and sexually transmitted diseases, Professor Shephard and his team used gold standard SARS-CoV-2 testing on the GeneXpert medical device. This provided access to accurate COVID-19 test results in 88 remote Aboriginal and Torres Strait Islander communities across Australia – generally beyond the reach of regional pathology laboratories.
“We first used GeneXpert technology nine years ago with the successful Test, Treat, ANd GO program, which was a world-first point-of-care testing network for sexually transmitted diseases in remote communities,” says Professor Shephard. “This laboratory device had never been taken into the field before, and it has provided the infrastructure necessary for effective COVID-19 testing.”
The speed that the Australian Government wanted this COVID-19 network set up was daunting, yet the response from the Flinders team and collaborating partners at the Kirby Institute (UNSW) was swift. After receiving federal funding in late April 2020 and commencing testing operation in early May, the program was running at full capacity by November 2020.
The Centre’s co-director Dr Susan Matthews says the program delivered more than 850 hours of training for remote health professionals to perform on-site tests using the GeneXpert. It has enabled more than 40,000 people in remote communities to be tested and obtain accurate COVID-19 results within 45 minutes, rather than a three-day turnaround for the same results from laboratory services – and this translates to more than 58,000 unnecessary patient isolation days that have been saved.
“Professor Shephard’s foresight of 20 years ago made this all possible,” says Dr Matthews.
Laboratory testing represents the gold standard in pathology analysis. Proving that point-of-care testing performed outside a pathology laboratory can have comparable high standards of analytical quality has been a major focus of the Centre’s work.
It now manages networks for chronic, acute and infectious disease that deliver clinical, cultural, operational and cost benefits for patients and the Australian health system.
The breakthrough program that proved the merit of point-of-care testing was QAAMS – the Quality Assurance for Aboriginal and Torres Strait Islander Medical Services program that uses point-of-care testing to manage and diagnose diabetes
in Indigenous medical services across Australia. QAAMS has been running for 22 years, and recently received another four-year extension of federal funding to ensure its ongoing work. Significantly, the pathology tests performed in QAAMS receive a Medicare rebate, underlining the program’s emphasis on analytical quality and capacity to improve diabetes control in remote communities.
The Centre’s next goal is to use the GeneXpert device to establish a point-of-care testing network in Australia for hepatitis C diagnosis, to help meet World Health Organization virus elimination targets by 2030. The Australian Government recently announced $6.5 million in funding for the Flinders University International Centre for Point-of-Care Testing and The Kirby Institute to establish a national testing program at 65 sites with a high prevalence of hepatitis C infection.
“We’ve proved that if point-of-care testing models are set up and managed well, the pathology results are comparable to laboratory tests and the clinical benefits for patients are undeniable,” says Professor Shephard.
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