Opening Pandora’s Box

OUR EDITOR ONCE AGAIN HAS ANOTHER REMARKABLE PREDICTION for the clinical laboratory industry. In this issue, he predicts new point-of-care (POC) technology for routine chemistry and hematology testing will start the long- foretold process of laboratory decentralization. This follows on the heels of the last issue of THE DARK REPORT, when he predicted that web-based lab test ordering/results reporting is about to become the preferred communications vehicle between clinical labs and physicians’ offices, in two years or less!

I had to take him to task on his newest prediction about the influence of point-of-care technology on centralized laboratories. After all, as you will read in this issue, CARESIDE, Inc.’s new point-of-care instruments for routine, high-volume chemistry and hematology tests are not yet available in the market, although that will change in the coming weeks.

Robert Michel, our editor defends his prediction with an interesting argument. He calls it the “Pandora’s Box Paradox.” In simplest terms, if CARESIDE’s new point-of-care chemistry analyzer is cost-competitive with routine chemistry tests now done in centralized core laboratories, then it will begin to nibble at the market share held by the big chemistry instrument vendors. You all know the names—Roche, Abbott, Beckman- Coulter, Ortho-Clinical Diagnostics, Bayer.

Editor Michel says that these diagnostic powerhouses are not going to let start-up companies like CARESIDE erode their market shares. These companies will defend their business by developing their own point-of-care solutions for high-volume, routine chemistry testing. Thus, CARESIDE’s launch of its new POC instrument suite is like opening Pandora’s Box. Like it or not, once the box is open, mischief is let loose on the world.

For my part, I argue that it is difficult for billion-dollar diagnostic companies to take CARESIDE seriously, particularly when its products have yet to demonstrate their performance in actual clinical use. Editor Michel has an interesting rebuttal. He points out that it took CARESIDE only 36 months and about $20 million to take existing state-of-the-art chemistry and hematology technology, and create a viable point-of-care instrument solution. He says that’s chump change for a billion-dollar company. Once they get serious, they can develop their own POC product—and fast! I guess if that happens, then CARESIDE really did open Pandora’s Box.


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