The issues become more dramatic in the analysis the more decentralized the health care system becomes. It is unclear how much of that savings was affected by a change in physician behaviors. A more dramatic example is illustrated in my medical group practice that concentrates on the homebound elderly. We now find the need for a specialized vehicle limited to imaging equipment, which can service multiple providers in a single region. One simple cost analysis we perform is decision-based at the time of the test.
Numerous examples occur daily in our home practice.
Serial electrolytes, base deficit, and hematocrits done at the bedside were critical in establishing the safety of such a procedure in the home. Her bedside testing measured a base deficit of minus 7 and led me to a diagnosis of abdominal angina and possible bowel infarction. She was transported to the hospital, where appropriate care saved her life. If validity studies are carefully done, and the instrument with its standard methodology passes the rigors of the Clinical Laboratory Improvement Act, you can trust the test perhaps more than one done in the main lab. However, other than the I-STAT, regulatory agencies have not taken into consideration any other machines currently available.