title: Implementation science: the laboratory as a command centre.
abstract: Recent advances in point-of-care technologies to ensure universal access to affordable quality-assured diagnostics have the potential to transform patient management, surveillance programmes, and control of infectious diseases. Decentralization of testing can put tremendous stresses on fragile health systems if the laboratory is not involved in the planning, introduction, and scale-up strategies.
  
  
  
  The impact of investments in novel technologies can only be realized if these tests are evaluated, adopted, and scaled up within the healthcare system with appropriate planning and understanding of the local contexts in which these technologies will be used.
  
  
  
  In this digital age, the laboratory needs to take on the role of the Command Centre for technology introduction and implementation. Implementation science is needed to understand the political, cultural, economic, and behavioural context for technology introduction. The new paradigm should include: building a comprehensive system of laboratories and point-of-care testing sites to provide quality-assured diagnostic services with good laboratory-clinic interface to build trust in test results and linkage to care; building and coordinating a comprehensive national surveillance and communication system for disease control and global health emergencies; conducting research to monitor the impact of new tools and interventions on improving patient care.
authors.affiliation: aLondon School of Hygiene and Tropical Medicine, London, UK bUS Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Debrah I
authors.initials: DI
authors.lastname: Boeras
authors.forename: John N
authors.initials: JN
authors.lastname: Nkengasong
authors.forename: Rosanna W
authors.initials: RW
authors.lastname: Peeling
mesh_terms: D064790:Clinical Laboratory Services / Q000458:organization & administration*; D019468:Disease Management; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology*; D006297:Health Services Accessibility; D006801:Humans; D019095:Point-of-Care Systems / Q000592:standards* / Q000706:statistics & numerical data*; D019562:Viral Load / Q000379:methods*