Choosing wisely: Improving decision-making for deployment of diagnostics in primary care settings

Abstract

Background: Despite the availability of WHO and ICMR’s list of essential diagnostics, there is limited guidance to primary care providers on choosing and deploying the most appropriate diagnostics. Objectives: The study aimed to identify diagnostic tests that are required in primary care settings and to review the identified tests’ availability, reliability, and ease of use. We also studied challenges faced by primary care physicians in deploying diagnostics. Methods: We interviewed 12 primary care physicians with diverse practices; the interviews were recorded, transcribed, and coded. We further reviewed and extracted data from published literature on diagnostics. Results: We arrived at a list of tests that are relevant for all primary care settings; as well as those that are required in specific settings, based on location (rural/urban); place of care (home based vs clinic), scope of services (comprehensive versus selective) and epidemiology. Limited guidance is available to direct physicians on choosing and deploying appropriate diagnostics. Conclusion: A landscape analysis, such as this, is required to enable primary care physicians to wisely choose and deploy appropriate diagnostics.

Keywords

• diagnostics
• point-of-care
• primary care