Laboratory test analysis near the patient. Opportunities for improved clinical diagnosis and management

New developments in laboratory technology have produced complex analytic systems that are simple to operate, relatively reliable, and inexpensive. These systems allow the office practitioner to perform test analyses in an office laboratory and can provide timely information useful for diagnostic and clinical management decisions. This article reviews the clinical applications and analytic systems available for use in urine analysis, blood cell analysis, determination of the sedimentation rate, coagulation testing, biochemical analysis, and bacteriologic and virologic testing. Although these analytic systems are generally designed to be used by nonprofessional laboratory staff, there is only limited information available about their reliability when used in this manner. Physicians, in bringing this technology into their office laboratories, must be cognizant of a new area of medical practice because they will now be the professionals responsible for the laboratory's function. It will be important that they develop new skills as the office laboratory directors and develop consultative relationships with laboratory professionals to ensure that the information used in patient care is both timely and reliable.