Speeding up respiratory diagnosis: clinical drivers, barriers, and system readiness for rapid molecular point-of-care testing in Saudi Arabia.

Background: Acute respiratory tract infections place substantial strain on healthcare systems, particularly during seasonal respiratory surges and mass-gathering events. Delayed confirmation of respiratory pathogens contributes to diagnostic uncertainty, unnecessary antimicrobial use, delayed infection prevention decisions, and inefficient patient flow. Rapid molecular point-of-care testing (mPOCT) offers near-PCR-level diagnostic accuracy with turnaround times compatible with real-time clinical decision-making; however, implementation and integration into routine clinical pathways remain variable across healthcare systems. Methods: We conducted an implementation-focused mixed-methods descriptive study integrating a synthesis of published evidence with structured stakeholder engagement in Saudi Arabia. Primary data were collected through three multidisciplinary scientific meetings and a stakeholder survey ( Results: Physicians represented 48.6% of respondents, with most participants working in MOH facilities (60.0%). Rapid mPOCT was reported to be routinely used during respiratory seasons, with 68.6% indicating daily use. Immediate treatment decision-making (74.3%) and patient management activities, including bed designation (57.1%), were the most frequently reported indications for testing. Nearly half of respondents preferred results within 15 min (45.7%), while most preferred turnaround times of 30 min or less (85.7%). Participants reported generally moderate-to-high implementation of rapid mPOCT (mean implementation score 7.69/10; range 2-10), although variability remained in guideline integration, standard operating procedures, and institutional implementation. Frequently reported implementation barriers included limited education or guidance (31.4%), perceived availability of alternative diagnostic approaches (28.6%), and financial or reimbursement constraints (28.6%). Conclusion: Saudi healthcare stakeholders perceived rapid mPOCT as a valuable diagnostic tool for respiratory infections, particularly in emergency and acute care settings where timely results may support clinical decision-making. Wider implementation will require standardized diagnostic pathways, workforce education, supportive governance, and sustainable reimbursement strategies to facilitate consistent integration into routine clinical practice.