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Decera Clinical Insights Podcast, Right Test, Right Setting, Integrating Rapid Point-of-Care Testing for Sexual Health into Practice
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Released: May 22, 2026

Roland C. Merchant
Roland C. Merchant, MD, MPH, ScD

This transcript was automatically generated from the audio recording and may contain inaccuracies, including errors or typographical mistakes.

Sara Thier: Welcome to Segment 2 of the Decera Clinical Insights Podcast, Right Test, Right Setting, Integrating Rapid Point-of-Care Testing for Sexual Health into Practice.

My name is Sara Thier, and I'm an Associate Medical Director at Decera Clinical.

I'm joined by Dr. Roland Merchant, the Assistant Dean for Faculty Development for Research, and Professor and Vice Chair of Research of Emergency Medicine at the University of South Florida Morsani College of Medicine.

In our first segment, Drs Joseph Cherabie and Jenell Stewart explored the clinical and patient-experience benefits of rapid point-of-care testing for sexually transmitted infections.

During this segment, Dr. Merchant will focus on what it actually takes to implement point-of-care testing, from budgeting and staffing to compliance and data reporting.

Welcome, Dr. Merchant. To frame this discussion, can you describe what you believe has driven the shift from conventional lab-based testing to point-of-care or rapid diagnostic testing for sexually transmitted infections?

 Dr. Merchant: Thank you, I'm happy to do so.

There's a difference between conventional laboratory-based testing, rapid testing, and rapid point-of-care testing.

Conventional laboratory-based testing involves obtaining samples from patients, either from urine or swabs, and then sending those samples to laboratories for analysis. These laboratories could either be at a healthcare facility or a commercial facility. Samples are usually processed in batches, as opposed to being tested one by one. Samples may not be processed and tested on the same day that they are received.

Because of the delay and the time that it elapses from sample collection to their delivery at these facilities, received at the laboratories and their processing, it could take several days before a patient receives the results.

And as a consequence, patients who are infected may have delays before they receive the treatment they need. And, thus, may unknowingly spread their infection to others. Furthermore, depending on the healthcare setting, it could be difficult to reach these patients to give them their test results, and for them to get the treatment that they need.

In contrast, rapid testing and rapid point-of-care testing for STIs overcomes many of the challenges of conventional laboratory-based testing. By rapid testing, I'm referring to tests that are performed at a laboratory quickly. Rapid point-of-care tests are patient bedside-type tests. For both rapid and rapid point-of-care tests, patients can receive the results and any treatment that they need during their healthcare visit.

In the United States, we've had rapid point-of-care testing for HIV and hepatitis C for several years. But recent technological advances have enabled rapid and rapid point-of-care testing for several SCIs, particularly for chlamydia and gonorrhea, which is a major step forward in improving sexual healthcare.

Sara Thier: Yeah, it sounds amazing how far rapid testing has come. Now, if a doctor or a clinic or any healthcare setting wants to integrate these rapid point-of-care STI tests, and let's focus on chlamydia and gonorrhea testing for this. What are the most important resources they need to evaluate upfront?

Dr. Merchant: Sure, if a healthcare facility or medical provider has decided to implement rapid testing or rapid point-of-care STI testing, they're probably doing so to make sure that their patients get tested and treated during the same patient visit. Their first question should be, “What type of STI testing is most appropriate, given the resources that we have?”

They need particularly to consider their physical space, their staffing, and their budget. So, in other words, how much space do they have for equipment and supplies? Who will perform the test? And what is the budget that they will need to acquire any equipment, pay for supplies, and hire and train staff?

The resources that are needed vary based on the type of setting, such as either a hospital, a freestanding emergency department, urgent care, community setting, such as a multi-specialty practice, or whether at a primary care setting, a sexual health clinic, or even a federally qualified healthcare facility, mobile or outreach service.

These places also must consider if they have their own laboratory on-site, and will their own staff conduct testing? How many tests will they perform? How will testing affect personnel time and workflow?

Machine-based rapid STI tests can be placed in a central laboratory, such as a hospital, or even a laboratory proximal to the clinical area, such as at a freestanding emergency department. Or, they could be at a designated testing space within the clinical area.

When testing is performed in a designated space near patients, then it becomes a rapid point-of-care test. In that situation, staff can prepare and test the samples themselves.

The newer rapid test machines provide test results for chlamydia and gonorrhea within about 20 to 30 minutes. But other than space and staffing and supplies, the cost of purchasing or renting these machines needs to be assessed. These devices work well for places that have these types of resources and have higher patient volumes.

Sara Thier: Yeah, it sounds like you would need a good budget for the machine-based tests. So, for smaller or community testing sites, who may not have that resource amount, or have lower patient volume, are there other options of tests for them?

Dr.  Merchant: There are other rapid point-of-care STI testing options, and these include handheld tests that can either be reused, or even single-use tests. These tests are better for outreach settings, such as community, mobile vans, and community-based testing, where the test volume is low, and staff have time to perform and wait for the test result.

Sara Thier: Yeah, that sounds like a much better option for those smaller sites. So how can these smaller sites effectively and efficiently integrate these tests, and who will typically be responsible for running the tests?

Dr.  Merchant: Integration of rapid testing or rapid point-of-care testing for chlamydia and gonorrhea often requires changes to workflow of smaller healthcare facilities or community-based or outreach or mobile clinics.

However, some of these facilities could have used similar point-of-care tests before, such as for HIV or hepatitis C, testing for urinary tract infections or pregnancy, and thus can adapt their workflows to also test for chlamydia and gonorrhea.

But, changes to the workflow will depend, based on the test they choose to integrate.

At one extreme are facilities that have a laboratory with laboratory staff dedicated performing testing. And for those types of facilities, the impact will be on the laboratory staff. The laboratory staff will have to perform these tests as they are received to take advantage of being able to provide the test results during the patient visit. This added staff burden varies by testing volume. If many patients are tested around about the same time, multiple machines are required.

At the other extreme are facilities that do not have a laboratory and do not have laboratory staff. The impact, then, is on the facility staff. Staff affected depends on the size and resources and mission of the facilities.

Locations without laboratory staff can only perform FDA-approved CLIA-waived chlamydia and gonorrhea rapid point-of-care tests. CLIA-waived tests can be performed, however, by a wide range of staff members who are trained on how to perform the test.

Sara Thier: And I'm assuming there's formal training for any staff member who will be performing the tests?

Dr. Merchant: Yes, training is required for anyone who is using these tests. However, manufacturers are happy to provide training. Outreach workers, medical assistants or technicians, nurses, advanced practice providers, and doctors can perform the test.

The type of staff that is available to perform these tasks affects the workflow, patient throughput, and also patient wait times.

If testing volume is low and staffing resources are larger, effects on staff and patients are smaller than if the volume is high and staff is limited.

Sara Thier: Yeah, that makes it challenging for those smaller settings.

There could be a staff burden for smaller organizations. So, in these smaller settings, where they can sometimes have a lot of staff turnover, how do these sites ensure the quality and accuracy of the tests and testing procedures?

Dr. Merchant: Any new staff member who's going to be using the test needs to be trained on sample processing testing. The facilities themselves, as well as their staff, need to be compliant with quality assurance. Quality assurance procedures will need to be implemented to ensure that the patients get the correct test results. Because errors in sample processing and testing are possible, facilities must include safeguards to ensure high performance quality. In addition, local and state regulations can affect these processes.

But there's been a recent change in typical practice that can help with staff workflow. Whenever possible, patients with vaginas can collect their own samples for chlamydia and gonorrhea testing, as long as samples are collected correctly. Sample collection can be much quicker, which can reduce staff burden, and time. Sample collection can occur before pelvic examination, which can further decrease time from sample receipt and processing.

Sara Thier: That sounds like a great alternative and a good way to sort of reduce a lot of the staff burden.

Let me turn to another topic, data connectivity, documentation, and billing. What… what do sites have to think of before implementation?

Dr. Merchant: So if a facility is using a machine-based test and has an electronic health record, the test results can be transferred directly from that machine to the record. Then clinicians could acknowledge and act on the test results directly.

Billing is usually connected to the electronic health record as well. The advantage of using a machine connected to an electronic health record is that reporting and documentation and billing is much easier and more accurate.

However, such sites will need to coordinate with their information technology group before they launch testing to ensure conductivity with the machines and the electronic health record. But a facility is using a non-instrument-based rapid test or does not have an electronic health record system, which could be the case for community outreach or mobile testing, the results will need to be manually entered in either the laboratory reporting system or the electronic health record, if they have one, and also their billing system, if they are billing for testing.

The barriers here are increased work burden on staff, as well as the need to ensure that the recording of results is accurate.

Sara Thier: Yeah, that's… that can be a burden. So, in addition to all that, how then do they do public health reporting if they have different types of connectivity models?

Dr. Merchant: So, public health reporting of positive test results for chlamydia and gonorrhea will be a change of procedures for these locations that have previously relied on laboratories to provide these results to public health authorities.

These types of locations will need to adopt procedures to ensure that they inform the public health authorities of infections in a timely manner per state and local regulations. So that they can enable effective contact tracing.

Sara Thier: That's also very important, very interesting that they need to know that they need to do that sometimes manually.

There's definitely a lot to consider and plan for when integrating these rapid point-of-care tests into practice, but the benefit to the patients and the overall public health definitely offsets any startup challenges.

Thank you, Dr. Merchant, for sharing your knowledge and insights. We hope this discussion has provided practical guidance on key integration and logistical considerations for rapid point-of-care STI testing. Thank you for listening.