Welcome to our readers.
We are joined today by Marc Winrow. Marc is currently the COO of Citizen Care Health Solutions, a Canadian based Health Tech company that develops POCT middleware.
Marc has spent over 25years in POCT and the IVD industry, working both internationally and the UK.
“I was excited when the opportunity to join Citizen Care came about, as for a long time I had heard POCT managers tell me about the challenges they face with connectivity, especially as testing became more decentralised. I struggled with these challenges myself from the device manufacturers point of view, where tests couldn’t be adopted & services couldn’t be put in place due to the lack of connectivity. Joining Citizen Care was my opportunity to develop and bring to market software that solved these issues and enabled the decentralisation of testing”.
Moderator – Tony Cambridge
TC: Hi Marc, it’s a pleasure to have you as a participant in our new series of blogs focussed on exploring hot topics in the point of care, rapid diagnostics and in-vitro diagnostics sector. You have significant experience in providing connectivity solutions for diagnostics in hospital and community settings and our readers will benefit from your insights.
Thank you for contributing your time so let’s jump straight in…
How do middleware solutions improve connectivity between point-of-care devices and the patient health record? Can we expect full integration any time soon and are the barriers solely financial?
MW: Middleware is the digital translator between POCT devices and the patient’s record. They are critical to ensure that results are captured automatically (eliminating the very real risk of transcription errors) but also ensuring that the results that are captured can be trusted in that both the device and the users have the appropriate levels of governance over them.
There have been historic issues with integration of POCT devices, especially as POCT is adopted in settings outside Hospitals. While financial constraints are real, the bigger barriers are legacy systems, and IT. Full integration is coming — but it requires cloud-first thinking and middleware that’s built for interoperability from day one.
How are other solutions (mobile apps/portals) bridging the existing gap in integration?
MW: Mobile apps and portals are helping clinicians capture POCT results at the point of care — especially in community or home settings. But many of these solutions operate in isolation or depend on manual entry, so the result is a fragmented system where many devices remain unconnected, or a myriad of individual apps to use. One of the most consistent topics of feedback from POCT managers has been the need to consolidate all these data silos.
What role does real-time data integration play in enhancing clinical decision-making in point-of-care testing?
MW: Real-time data integration plays a pivotal role in enhancing clinical decision-making in Point-of-Care Testing (POCT) by ensuring that diagnostic insights are instantly available and actionable within a patient’s care pathway.
Real-time integration ensures POCT results automatically populate into the Electronic Patient Record (EPR), where they are accessible alongside other clinical data. This avoids fragmentation and ensures clinicians can make decisions with a complete, up-to-date view of the patient’s status.
With the rise of virtual wards and decentralised diagnostics, real-time data integration allows Trusts to monitor patients in the community and intervene before conditions deteriorate. This is especially useful for managing chronic conditions, infections, and frailty.
Additionally, POCT results can feed directly into clinical decision support systems (CDSS), which can trigger alerts for abnormal values, suggest clinical pathways, or flag at-risk patients. This reduces the risk of oversight and supports evidence-based care at the bedside.
How are AI-driven analytics supporting clinicians in interpreting POCT results more effectively?
MW: AI is transforming POCT from reactive to predictive. embedded AI tools help identify abnormal patterns, flag risks, and even suggest next steps — all in the context of a patient’s clinical history. This doesn’t replace the clinician; it enhances their decision-making with timely, relevant insights. However, it’s critical that the AI is validated for its accuracy. Data sources can vary in quality and the AI needs to be able to interpret the data in context (e.g., normal range varies by patient age, condition, or test method).
It requires clear explainability of the process and human oversight. Clinicians need to understand and trust the output. “Black Box” models are hard to defend in clinical settings.
AI does not need to clinically be focused to have benefits to POCT though. There are many other ways it can support POCT programs that focus on its core strengths.
What are the challenges in implementing connectivity software across diverse POCT platforms in multiple clinical areas?
MW: The biggest challenge is fragmentation — different departments, different devices, different networks & IT systems and different expectations. Many POCT platforms use proprietary formats or did not properly consider connectivity till they came to market.
There are solutions to these problems, but with legacy IT systems and software it can be costly.
Moving to cloud-based systems can overcome many of these challenges and enable connectivity & standardisation across multiple sites, even regions.
How can clinical decision support software reduce diagnostic errors and improve patient outcomes?
MW: When clinical decision support software (CDSS) is integrated with POCT results, it adds a safety net. Middleware can then flag abnormal values, cross-references patient history, and can prompt clinicians with next steps — helping to reduce cognitive load and diagnostic errors. It’s like having a digital second opinion, embedded in every test.
What cybersecurity concerns arise when connecting POCT devices in the community and to broader hospital networks, and how can they be mitigated?
MW: Cybersecurity is non-negotiable. As more POCT moves into community and remote environments, Trusts must secure both the devices and the data pathways. The top cyber security concerns would be; unsecured network connections, device vulnerabilities, lack of encryption, insecure authentication & lack of IT oversight in the field.
These however can be overcome.
Use End-End Encryption, ensuring all data both at rest and in transit is encrypted.
Deploying cloud-based middleware with built in security that is always running the latest security updates.
Enforcing strong authentication, such as MFA.
Securing the device layer on tablets and phones used for POCT.
Using Secure encrypted VPN to access networks.
These are just some of the basics that can be done to ensure the security of data.
Much of this is covered in Cyber Essentials, NHS DSPT and ISO27001.
How does connectivity software support regulatory compliance and audit readiness across POCT services?
MW: Compliance isn’t just a checkbox — it’s foundational. Middleware can log every test, user, and device interaction, creating a full audit trail aligned with ISO 22870 and 15189 standards. POCT teams can generate compliance reports, monitor training requirements, and proactively manage incidents.
Increasingly AI can be used to support regulatory compliance and audit readiness preparation
What future trends in connected healthcare could further transform the impact of decentralised diagnostics on patient care?
MW: We’re heading toward fully integrated, patient-centred diagnostics — where POCT results (in both hospital and community settings), wearable data, and remote monitoring are seamlessly unified. Middleware will be the enabler — ensuring data flows safely, instantly, and intelligently between patients, clinicians, and systems. The future is decentralised, intelligent, and deeply connected.
POCT is no longer just about the device. It’s about the data — and what you do with it. Modern POCT Middleware will help NHS Trusts unlock the full potential of POCT through secure, cloud-native systems that puts real-time insight in the hands of those who need it most.
TC: This is a very thought-provoking topic especially in view of the release of the 10-year plan and an expected shift towards out-of-hospital care where capturing diagnostic results and health interactions in one central solution will be the goal. Your experience and shared learning will be very valuable to the readers.
Thank you to Marc Winrow for sharing his expertise and participation in this blog series.
Contact – marc.winrow@citizencarehealth.com
Point of Care Blog series 1 : Blog 4 coming soon…
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The company was set up in 2018 by Tony Cambridge MSc. BSc. Lead Biomedical Scientist, who is the managing director. With over 20 years experience in Blood Sciences and more recently Pathology management, Tony set out to provide affordable training opportunities to healthcare organisations through a number of different ways, from small group seminars to…