Establishing PoC clinics in remote Aotearoa New Zealand to screen for HPV

Recent technical advances make it increasingly possible for non-experts to perform complex molecular diagnostic screening tests at the point-of-care (PoC) (e.g. medical centres, mobile clinics, pharmacies). However, these facilities must comply with codes of best practice to provide safe services for patients. This is often not straight forward despite apparent 'plug-and-play' offerings from commercial PoC diagnostic companies. As part of a research project, three existing primary care clinics were configured to offer PoC to screen for HPV, complying with the New Zealand Best Practice Guidelines for Point-of-Care Testing, that encompassed infrastructure, staff training and performance measures. These rural primary care health centres served a predominantly Maori population and the PoC platform chosen was the Cepheid GeneXpert IV. All three clinics encountered different challenges but generally met New Zealand best practice guidelines including expected HPV detection rates and quality assurance measures. Our work shows it is possible to implement PoC screening in remote clinical settings but requires technical oversight and consideration of the whole-of-clinic set up in order to offer a safe and best-practice service.