Portable COVID-19
pathology passes the test

Professor Mark Shephard

Dr Susan Matthews

COVID-19 has afflicted global populations with devastating speed – and has exposed the vulnerability of Australia’s remote Indigenous communities. Fortunately, Flinders University’s Professor Mark Shephard devised portable and rapid diagnostic test systems that had been more than 20 years in the making.

Professor Mark Shephard

Dr Susan Matthews

Professor Shephard is director of the Flinders University International Centre for Point-of-Care Testing, a groundbreaking unit that is a global leader and advocate for point-of-care testing research, teaching and innovation. Since 1996, this team has taken pathology testing that was previously only available in laboratories and managed its use in primary care settings across Australia and internationally.

Molecular point-of-care testing has proved invaluable in diagnosis of COVID-19 throughout remote Australia. Embedding successful elements for remote point-of-care testing of diabetes and sexually transmitted diseases, Professor Shephard and his team used gold standard SARS-CoV-2 testing on the GeneXpert medical device. This provided access to accurate COVID-19 test results in 88 remote Aboriginal and Torres Strait Islander communities across Australia – generally beyond the reach of regional pathology laboratories.

“We first used GeneXpert technology nine years ago with the successful Test, Treat, ANd GO program, which was a world-first point-of-care testing network for sexually transmitted diseases in remote communities,” says Professor Shephard. “This laboratory device had never been taken into the field before, and it has provided the infrastructure necessary for effective COVID-19 testing.”

The speed that the Australian Government wanted this COVID-19 network set up was daunting, yet the response from the Flinders team and collaborating partners at the Kirby Institute (UNSW) was swift. After receiving federal funding in late April 2020 and commencing testing operation in early May, the program was running at full capacity by November 2020.

The Centre’s co-director Dr Susan Matthews says the program delivered more than 850 hours of training for remote health professionals to perform on-site tests using the GeneXpert. It has enabled more than 40,000 people in remote communities to be tested and obtain accurate COVID-19 results within 45 minutes, rather than a three-day turnaround for the same results from laboratory services – and this translates to more than 58,000 unnecessary patient isolation days that have been saved.

“Professor Shephard’s foresight of 20 years ago made this all possible,” says Dr Matthews.

“His leadership and mentoring in this field meant there was already a proven model and a capable scientific team in place to deliver a successful program, with an emphasis on quality and safety that would be expected of an accredited pathology laboratory.”

Laboratory testing represents the gold standard in pathology analysis. Proving that point-of-care testing performed outside a pathology laboratory can have comparable high standards of analytical quality has been a major focus of the Centre’s work.

It now manages networks for chronic, acute and infectious disease that deliver clinical, cultural, operational and cost benefits for patients and the Australian health system.

The breakthrough program that proved the merit of point-of-care testing was QAAMS – the Quality Assurance for Aboriginal and Torres Strait Islander Medical Services program that uses point-of-care testing to manage and diagnose diabetes

in Indigenous medical services across Australia. QAAMS has been running for 22 years, and recently received another four-year extension of federal funding to ensure its ongoing work. Significantly, the pathology tests performed in QAAMS receive a Medicare rebate, underlining the program’s emphasis on analytical quality and capacity to improve diabetes control in remote communities.

The Centre’s next goal is to use the GeneXpert device to establish a point-of-care testing network in Australia for hepatitis C diagnosis, to help meet World Health Organization virus elimination targets by 2030. The Australian Government recently announced $6.5 million in funding for the Flinders University International Centre for Point-of-Care Testing and The Kirby Institute to establish a national testing program at 65 sites with a high prevalence of hepatitis C infection.

“We’ve proved that if point-of-care testing models are set up and managed well, the pathology results are comparable to laboratory tests and the clinical benefits for patients are undeniable,” says Professor Shephard.

“What we achieved in the face of COVID-19 shows that the speed, efficiency and quality of our work can directly inform health policy – and it shows unequivocally how point-of-care testing can be game-changing in emergency response situations.”

International Centre for Point-of-Care Testing

Professor Mark Shephard

Dr Susan Matthews

BRAVE MINDS

Discover how Flinders is making a difference to our culture, economy, environment society and world.

Download Brave Minds

View website

Subscribe to Flinders research

Sign up to get updates on upcoming events, news and more.

_{I consent to the collection, processing and disclosure of the personal information submitted in accordance with the Flinders University Privacy Policy.}