Point-of-care research: a new series for Nursing Research.

What images come to mind when you hear the phrase “point of care”? Do you visualize a nurse advising a mother about her child’s minor ailment in the clinic or a nurse helping a patient get out of bed in the ICU? Whatever you envision, some intersection of patient, nurse, place, and time is likely part of the picture. In the past, the point of care was taken to be a setting—hospital, clinic, infirmary— designed specifically to provide health services at specific times by specific providers to specific people with specific conditions or concerns in specific ways. Now, radical changes in technology and information, consumer expectations, demographics, health economics, and political action are revolutionizing the way care is provided. This perfect storm is upending conventional notions about point of care and opening new opportunities and challenges for nursing research. The incredible expansion of mobile cellular subscriptions— projected to reach almost 7 billion by the end of this year (International Telecommunication Union, 2014)—may be the most significant factor allowing the point of care to extend from traditional settings to the point of living, wherever it may be. First smart handheld devices and now computers incorporated into the mundane stuff of everyday life like t-shirts have allowed generation of the quantified self-movement (Wolf, 2010). Selfcollection of personal health data on-the-go was coemergent with ideas for novel patient-driven healthcare models (Swan, 2009), the potential of which has been little explored or utilized. The same handheld, interconnected, smart technology generated themove for m-health that allows “point of care in your pocket” for healthcare providers (van Heerden, Tomlinson, & Swartz, 2012). Try a quick search of MEDLINE using “point of care” as keyword; in over 10,000 hits, you’ll find that lab testing and use of devices at the bedside in hospitals, in long-term care units, in homes, and in the field are fast changing theway assessments are done and treatment decisions are made (Bier & Schumacher, 2013; Walia, 2013). Telehealth is extending the reach of place-bound providers to the technology-mediated point of care (Institute of Medicine, 2012). Evaluation of quality in point-of-care testing and telehealth interactions is needed, however. Wireless technology and the Internet of things (IEEE Standards Association, 2014) are creating smart environments for the point of care. Smart, patient-centered ICUs designed for healing and capitalizing on information provided by sensors and devices are envisioned (Halpern, 2014). Sensor and