Theory, principles, and practice of optimizing point-of-care small-world networks

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10 Scopus citations


A health care small-world network (SWN) evolves naturally from social interactions and population dynamics. However, during a crisis, the SWN becomes constrained by interrupted transportation within the limited geographic topology. Hence, practice principles for optimizing point-of-care (POC) testing in SWNs are designed to enhance emergency care, disaster preparedness, and public health response at both local province (ie, SWN) and global regional levels. Monitoring and diagnostic technologies, strategically located at network nodes and hubs, improve workflow and accessibility of critical information for rapid decision-making. The physical SWN(p), when transformed into a virtual time domain network, SWN(t), anticipates dynamics of successful responses and rescues. SWN(t) reveals why POC testing, such as fingertip oxygen saturation monitoring in ambulances and handheld cardiac biomarker testing in community hospitals, has high impact during complex emergencies and natural disasters-rapid test results optimize therapeutic turnaround time, the time from test ordering to treatment locally, while accelerating overburdened care paths globally. When there is no crisis, daily use of POC testing in the SWN improves the efficiency of physicians, nurses, and patients alike. In low-resource settings, not the cost, but the integrated net value of POC testing within the SWN represents the most significant metric. Especially in regions of heterogeneous population clusters where people in need may not have immediate access to tertiary care facilities, the POC SWN concept will be enhanced by determining provincial priorities based on demographic resource scoring, by use of geographic information systems, and by linking individual SWNs in broader regional collaborations for optimal resilience.

Original languageEnglish (US)
Pages (from-to)96-101
Number of pages6
JournalPoint of Care
Issue number2
StatePublished - Jun 2012


  • Acute myocardial infarction
  • ambulance
  • and tsunami
  • cardiac biomarkers
  • Cobas h232 (Roche Diagnostics
  • community hospital
  • Isaan
  • O saturation monitoring
  • physical domain
  • primary care unit
  • pulse oximeter
  • regional hospital
  • Thailand)
  • therapeutic turnaround time
  • time domain
  • transformation

ASJC Scopus subject areas

  • Nursing(all)


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