## 7 Challenges and Barriers to Implementation  
While the integration of POCT and digital health passports into workplace settings offers substantial promise, several challenges must be carefully considered and addressed. Privacy concerns remain paramount. Despite technological safeguards, employees may harbor fears regarding the potential misuse of their personal health information, whether for employment decisions, insurance discrimination or surveillance purposes. Building trust through transparent policies, voluntary participation and third-party oversight is critical to mitigating these fears [79]. Technological barriers can also impede implementation. Reliable internet connectivity, secure device infrastructure and interoperability between POCT devices and digital health platforms are prerequisites for successful deployment. Organizations operating across multiple sites, including remote or resource-limited environments, may face particular challenges in ensuring consistent access and data integration. Furthermore, the quality and reliability of POCT results must be rigorously managed. Variability in device performance, user error and environmental factors can compromise diagnostic accuracy. Establishing standardized protocols, training personnel and participating in external quality assessment programs are necessary measures to uphold clinical validity [69]. Mitigating the risks of POCT is essential for ensuring diagnostic reliability, clinical safety and trust in decentralized health systems. For a POCT system to be considered reliable, it must be followed by confirmatory laboratory testing for positive or ambiguous cases (including performing daily internal QC with known positive and negative controls), while orthogonal testing is recommended when appropriate (different methods or anti gens) [85; 86]. It is also advisable to use internal controls and calibration verification in the POCT device to detect errors or degradation. POCT faces several key challenges that hinder widespread clinical adoption. Ensuring high sensitivity and specificity is critical to accurately detect biomarkers in complex biological samples. Biomarker validation remains a major hurdle, as candidate biomarkers must be clinically verified. The development of user-friendly, affordable devices for decentralized use is still limited. While nanomaterials improve biosensor performance, optimizing their integration is complex. Wearable biosensors for real-time monitoring are promising but difficult to engineer, especially regarding fluid handling and miniaturized immunoassay. Cost and accessibility must be addressed for broad adoption, particularly in low-resource settings. Many technologies remain in the research phase, with few tested on real patient samples. Further, automation and miniaturization are required to make devices portable and practical. Finally, the development of reagent-free biosensors that offer low-cost, real-time results remains an unmet goal. Tackling these challenges is vital to advancing POCT for chronic disease diagnosis and management. Regulatory uncertainty poses another barrier. Rapid technological innovation often outpaces legislative frameworks, creating ambiguity regarding the legal status of emerging digital health applications. Proactive engagement with regulators, legal counsel and ethics committees can help navigate this evolving landscape. Finally, the financial costs associated with purchasing POCT devices, implementing digital health platforms and maintaining cybersecurity infrastructure must be weighed against anticipated benefits. Although preventive health strategies typically offer favorable long-term returns on investment, initial resource allocation remains a critical consideration. Advances in the IoT have expedited healthcare delivery to patients. Slow, steady IoT equipment operation is outdated. The telehealth service delivery model was put to the test during the pandemic.