Health systems across the country are taking different approaches to triaging and testing patients for the coronavirus.
Some are triaging and testing patients via drive-thru while others have developed in-house tests. Here is a brief outline of several different approaches.
1. In-house tests
Some health systems, including Rochester, Minn.-based Mayo Clinic and Pittsburgh-based UPMC, have developed their own COVID-19 tests. Mayo was able to develop its test in less than a month and submitted data to the FDA for emergency use authorization. The system's lab aims to process around 300 tests per day initially and increase that to 600 tests within a few weeks. UPMC also instituted in-house testing and hopes to eventually open additional collection sites as it ramps up production to hundreds of tests per week. UPMC implemented a requirement that patients obtain a physician referral that is then approved by its infection prevention team to undergo testing. Atrium Health in Charlotte, N.C., offers in-house testing for select patients with a nasopharyngeal swab that can produce results in three to 24 hours. The lab has the ability to process 1,000 tests per day. Find out more about health systems with in-house testing here.
Dartmouth-Hitchcock Medical Center in Lebanon, N.H., is testing for novel coronavirus at its laboratory. The testing became available on March 18 and the lab can perform up to 1,000 tests per day. However, a shortage of testing supplies and personal protective equipment will limit the testing to just hospitalized patients within the system as well as healthcare workers who have been in contact with COVID-19 patients. The system expects turnaround time for the test results to be 24 hours after the lab is fully operational.
2. Patient billing
Chicago, Ill.-based CommonSpirit, which includes hundreds of hospitals in 21 states, suspended patient billing for testing and treatment related to COVID-19. Dignity Health, part of CommonSpirit, is only offering tests to individuals with symptoms that are recommended for testing, but does have video visits available for any individual, regardless of whether they are symptomatic and free virtual care visits for patients with mild COVID-19 symptoms. Renton, Wash.-based Providence and Advocate Aurora Health in Milwaukee and Downers Grove, Ill., also suspended billing for COVID-19 testing and treatment.
New Hyde Park, N.Y.-based Northwell Health reported it would delay bill patients for patients who are symptomatic and have traveled to countries with COVID-19 exposure. Northwell Labs began semi-automated testing for COVID-19 on March 11 to process hundreds of samples per day. The system asks all others concerned about COVID-19 exposure, but who are asymptomatic, to stay at home.
3. Drive-thru locations
Advocate Aurora Health based in Milwaukee had planned to roll out drive-up testing sites at six hospitals over a week's time, according to a March 18 report in the Milwaukee Journal Sentinel. The sites were designed for patients with symptoms of COVID-19 and individuals would be screened and then receive approval before undergoing the tests. However, the health system halted plans for drive-thru testing sites due to a national shortage of supplies. The system maintains its online COVID-19 Symptom Checker, which will triage symptomatic patients to the next step.
Both Kaiser Permanente and Providence have opened up drive-thru testing sites in California. Kaiser's sites require a physician's referral and took 46 samples in one day last week. Kaiser follows the CDC criteria for testing, and health plan members won't need to pay for COVID-19 screening or testing. Medical University of South Carolina Health in Charlotte, N.C., also extended its virtual care platform to offer drive-thru respiratory specimen collection for COVID-19. The health system has free online coronavirus screenings through its virtual urgent care platform, and patients who are screened as "high risk" can obtain a test. Patients must first conduct a telehealth visit and if they are at high risk, they can have their specimen collected and tested for COVID-19.
4. Patient triage
Hackensack (N.J.) Meridian Health started using a tool on March 12 combining the CDC and World Health Organization diagnostic tools to accelerate test results for COVID-19. The test speeds up triaging of patients so they can be tested for novel coronavirus if necessary within hours, and the health system estimated it could test 24 patients every eight hours.
UCLA Health provides COVID-19 testing to patients referred by a physician, often via telemedicine, at a location with eight rooms. The health system can test 155 patients per day. The system also has testing at 14 primary care sites.
Contact Laura Dyrda at ldyrda@beckershealthcare.com to add information to this article.