Point-of-care testing (POCT) technology has the capacity to change the landscape of infectious disease burden, through rapid detection and earlier treatment. However, scaling up infectious disease POC testing requires understanding of a broad range of system-related factors which can influence accelerated implementation. This qualitative study sought to understand these systems level enablers and barriers and facilitators to national scale up of infectious diseases POCT in primary care settings in Australia. Specifically, this social science research project aimed to identify opportunities for integrated, multi-disease (infectious diseases) service provision of point-of-care testing supported by national and state/territory health systems within Australia.

Methods:

Stakeholder interviews were undertaken with 30 people (predominantly) working in high level positions relevant to scale up of infectious diseases POCT. Participants with diverse knowledge about infectious disease POC testing scale up (e.g. including population-specific health expertise, infectious disease/s expertise, health economics, workforce training, accreditation, pathology, and/or technology), and working across various settings (e.g., federal and state government departments, non-government national peak bodies, industry, and academia) were recruited. Analysis was informed by the WHO health systems building blocks including service delivery, health workforce, health information systems, access to essential medicines, financing, leadership / governance.

Results:

Barriers to scale up of infectious diseases POCT in primary care settings were broadly perceived as occurring at the regulatory level, including gaps in regulatory approvals (governance) and funding to ensure sustainability (financing). Ensuring a trained health workforce, robust connectivity, and reporting systems and guidelines (health information systems) were considered paramount for scale up to be successful. Advocacy and leadership were deemed critical to instigate the health systems change necessary to support infectious diseases point-of-care scale up.

Conclusions:

Whilst there is broad support for the accelerated implementation of infectious diseases POC testing scale up in primary settings nationally, several hurdles must be overcome to better enable accessibility of market access for POC technology and ensure sustainability of POC implementation in primary care