POCT also has disadvantages that impact multiple aspects of the process and outcomes. Some disadvantages of POCT include:
- Management of the testing: A large number of personnel may perform testing at multiple sites. Transporting equipment and test kits, as well as inventory and maintaining appropriate stock levels of kits and supplies, also adds to the challenge of managing the POCT process.
- Number of testing personnel: POCT frequently encompasses many operators with various job titles and responsibilities.
- Testing personnel locations: Administrative oversight is challenged by the lack of a central testing location.
- Cost per test: Individual cost per test may be higher than tests performed on a large volume platform in the central laboratory. The increase in per-test cost results from multiple factors, such as low test volume in the POCT location(s) and higher cost of individual test materials. Test systems utilizing enclosed cartridges analyzed by a POCT instrument may have higher costs per test cartridge. Conversely, the overall cost of patient care may be lower when POCT is employed as it allows patients to be treated or processed quicker through the healthcare system, reducing the cost of patient care.
- Documentation: Appropriate documentation may be challenging due to testing and personnel location, administrative oversight of personnel, and storage of records. Data requiring documentation and records for retention include:
- Test orders
- Test results (including normal range values and units)
- Operator identification (ID)
- External and internal quality control (QC) results
- Proficiency testing
- Electronic interfacing: POCT instruments may not be interfaceable or require specific docking stations or middleware, both of which add to the cost of the testing and the level of management required by the primary location. The laboratory information system (LIS) and the electronic health record (EHR) present this challenge.
- Monitoring and appropriate storage of supplies and reagents: Standardizing and monitoring the storage of POCT reagents and QC materials in decentralized and remote locations may be difficult.
- Errors: Error management can be difficult to track and monitor due to decentralized testing and diminished direct oversight. Error significance varies with testing location.
