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

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