Low-threshold diagnostics to a sustainable and preventive healthcare system

Niederschwellige Diagnostik am beispiel eines Corona Selbsttests
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Low-threshold diagnostics to a sustainable and preventive healthcare system

Niederschwellige Diagnostik am beispiel eines Corona Selbsttests

In recent years, diagnostic testing has become increasingly important, especially after the COVID-19 pandemic. In particular, points-of-care (POCT) or pharmacies are used for rapid diagnostics. At the same time, the health awareness of the population has been steadily increasing for years, leading to a high demand for health tests to control and monitor their own health. The increasing prevalence of chronic diseases in Western industrialized countries also means that there is an ever greater need for control tests. Low-threshold diagnostics can comprehensively meet this new demand.

POCT and laboratory testing at pharmacies offer the opportunity to make diagnostic management more innovative, efficient, and low-threshold:

1. Prevention rather than reaction for sustainable health care: The importance of low-threshold diagnostics


Blood values can be an indication of disease, so early check-ups can lead to investigations and further measures. The need for specific screening exists especially for people who have a family history or belong to a risk group. Many diseases only become noticeable when they have reached an advanced stage. Low-threshold diagnostics through comparatively inexpensive health tests contribute to society as a whole by detecting early-stage diseases, reducing complex treatments and intensive complications, and thereby preventing high treatment costs for the statutory health insurance system resulting from many visits to the doctor, intensive treatments, and expensive medications. Diagnostic tests are then an important tool for thinking proactively about health and for relieving the burden on the solidarity system by shifting the financial burden from costly treatment to low-cost, low-threshold prevention.



2. Sustainable disease management through low-threshold testing options


The increase in multimorbidity and chronic diseases, which is not only due to demographic change, will lead to an increasing use of diagnostics for monitoring and controlling diseases in the future. Low-threshold diagnostics can contribute to better disease management through continuous monitoring. Additional linkage to primary care, such as through telemedicine treatment services, can even reduce hospitalizations. Sound diagnosis-based knowledge of the patient’s current diseases also leads to informed treatment decisions and a higher quality of care.




3. Increase in low-threshold diagnostics: further development of telemedicine through area-wide testing options close to home


The usefulness of low-threshold diagnostics also arises from the fact that many diagnostic tests are currently not easily and quickly available to patients, but are only offered in doctors’ practices or even hospitals. Especially for older, chronically ill patients and those with limited mobility, there is a need for comprehensive testing facilities close to home. This need can be met for certain types of tests by pharmacies or laboratories with testing capabilities in combination with telemedicine offerings by enabling intelligent software solutions to facilitate exchanges between telemedicine doctors, patients, and laboratories. Digitally connected testing supports the expansion of telemedicine through point-of-care offerings and pharmacies for laboratory tests, adapting to the needs of patient groups.




4. Relief for medical practices through low-threshold diagnostics


Another aspect in favor of low-threshold diagnostics is time. If diagnostic tests are accessed through the office-based doctor, an appointment is necessary and is often not available until days or weeks later. When visiting the doctor on-site, there is usually a waiting time in the practice, and vulnerable patients are exposed to an unnecessary risk of infection. Moreover, for chronically ill patients who need to have their values checked regularly, often only the test result is sufficient. In the event of a progressive shortage of doctors, tests in the doctor’s office tie up capacity that could be used more wisely for more intensive treatment because necessary laboratory values can also be collected in pharmacies during telemedicine consultations. The patient no longer needs to visit a general doctor to collect samples, facilitating telemedicine-based all-around care.




5. Overcome error-prone self-testing


Point-of-care and pharmacy examinations also have the additional advantage over diagnostic tests that have to be evaluated in the laboratory, the results are available after a short time, since, on one hand, the transport of the samples to a specialized laboratory is not necessary and, on the other hand, no consideration has to be given to time schedules of the laboratory. In principle, however, it is advisable for both types of tests to be carried out in appropriate facilities in order to avoid incorrect application. In contrast to self-tests, they are therefore not highly error-prone, since samples are taken by trained personnel.




6. Promote health-conscious behavior through low-threshold diagnostics


Pharmacies allow people to keep track of their health in a low-threshold, quick, and easy way. The demand for regular check-ups to track one’s health is steadily increasing, giving health-conscious individuals insight into whether their diet is balanced or whether they have a vitamin deficiency. The trend toward informed patients who want to play an active role in shaping their health should therefore be supported by low-threshold diagnostics because health-conscious behavior and health literacy reduce the morbidity of the population and save costs in the health care system in the long term.




7. Collection and use of health data


Laboratory diagnostics provide several data points that, when combined with other data, have the potential to create personalized treatments and better outcomes, but also to target health threats of global scope, such as the COVID-19 pandemic.

Implementation of future-proof diagnostics management: safeguarding remuneration and efficient information exchange

The goal must be to transfer alternative testing options and low-threshold diagnostics into the standard care of the statutory health insurance. This is for the benefit of the citizens and improves the overall health of the population. In the future, there should be a mix of self-pay and health insurance benefits for this purpose. For example, if a patient uses a telemedicine consultation and laboratory results are required, the patient should be given the option of having his or her laboratory results determined at a pharmacy for sample collection without waiting times, and the results should then be sent to the physician for evaluation. As with the office-based physician, this should be a health insurance service that can be billed to the Association of Statutory Health Insurance.


It would also make sense for health insurers to expand diagnostic tests as part of nutritional counseling or preventive services. For customers who would like to have a nutrient analysis done to track their fitness, this can be offered as a self-pay service as before. Preference should be given to performing these services in pharmacies, as they tie up fewer financial and time resources than doctor services from an overall economic perspective.


An efficient, secure exchange of information among the various players in the healthcare system, ensured by innovative software solutions, is essential to implement. Test results must be available quickly and without complications in the laboratory, to the responsible doctor and to the patient concerned. To enable the development of such offers, close cooperation between the various players is necessary, as well as to secure remuneration as a further pillar of outpatient care.


Point-of-care solutions and laboratory tests in pharmacies will not replace diagnostics in doctors’ offices, but they offer an important complement to bring them closer to citizens and strengthen prevention and early detection of diseases through the use of smart software solutions. Greater integration of diagnostics into the care pathway through closer collaboration with laboratories, practitioners, patients, and payers has the potential to reshape healthcare. To achieve this goal, a low-threshold offering of pharmacies should be created to promote new approaches to care and the digitization of the German healthcare system. This can be achieved by making pharmanies a complement to telemedicine services as another pillar of primary care to provide easy, fast, and reliable access to health testing for health-conscious, as well as chronically ill individuals. In this way, low-threshold diagnostics make health care more preventive rather than reactive.