Newsbytes

How LigoLab simplified the SARS-CoV-2 testing process

November 2020—As LigoLab was designing a direct-to-consumer portal for laboratory testing early this year, company CEO Suren Avunjian turned his focus to when in 2021 he would release it, not knowing what was around the corner. But as the number of COVID-19 cases grew to pandemic proportions, Avunjian realized he could and should redesign the portal to streamline SARS-CoV-2 testing.

With its pedal to the metal, LigoLab developed the Web-based patient platform TestDirectly to support laboratory test ordering and digital workflow for SARS-CoV-2 testing, Avunjian says. More specifically, the product captures requisition information through a barcoding system that simplifies specimen intake by automatically transferring data from the platform into the laboratory information system. TestDirectly can integrate with any LIS but “works very well with our system out of the box,” Avunjian says.

As laboratories struggled to ramp up testing during the early weeks of the outbreak, paper requisitions became the bane of many a lab, Avunjian explains. Because much of the testing was for new patients numbering into the thousands, laboratories could not handle the onslaught of requisitions, nor could they provide results in a timely manner. “So the idea was, let’s close the loop for labs, patients, testing facilities, and government agencies by having a streamlined system where the patient is doing the registration piece” and the results are automatically communicated back to the patient through the portal, he says.

Since its release in April, TestDirectly has processed more than two million tests and has been implemented by laboratories in eight states, according to Avunjian. State and county departments of health have used the platform to provide baseline testing for long-term care facility and correctional center populations. More recently, sales are growing among companies that operate cash-payment drive-through collection sites and those that provide on-site workplace testing for the entertainment industry.

TestDirectly’s workflow is simple, Avunjian says. A patient locates a testing site via a search in the platform’s zip code directory and schedules an appointment. The system then generates and retains an electronic requisition and sends the patient an email containing a quick response code that encodes the order information. Test administrators at the collection site scan the QR code from that person’s smartphone.

The collection site module can be used anywhere, from correctional facilities to community testing sites, Avunjian says. For example, if a patient checks in at lane four of a drive-through location, the system can print the patient’s specimen label at lane four. The platform is integrated with Zebra printers for label printing, but collections sites can use prelabeled transport vials, he adds.

After the specimen is collected, test administrators scan the specimen label barcode and the patient’s QR code into the platform’s frontend interface to associate the transport vial with the corresponding patient’s electronic requisition. At a collection site’s close of business, staff generate a specimen manifest that Test­Directly sends electronically, with all patient orders for the day, to the associated laboratory’s LIS. Because each transport vial is already associated with a requisition, Avunjian says, the specimens can be processed immediately upon arrival. Once processed, the analyzer releases results to the LIS, which in turn forwards PDF reports to TestDirectly. The platform then sends texts or emails directing patients to log in for test results.

The system has worked well for Northwest Laboratory, in Bellingham, Wash., according to chief operating officer Jennifer Bull. Test­Directly, which Northwest implemented with its LigoLab LIS in May, has reduced the laboratory’s turnaround time for SARS-CoV-2 testing by about half, says Bull, who, along with Avunjian, conducted a presentation on TestDirectly at the 2020 Executive War College.

Halfway across the country, in Pekin, Ill., Reditus Laboratories CEO Aaron Rossi, MD, is also touting the benefits of TestDirectly. “The biggest bottleneck with getting specimens in the lab is the intake and accessioning portion,” says Dr. Rossi. In July, Reditus implemented TestDirectly via its LigoLab LIS at a drive-through testing site run by the DuPage County Health Department, in Wheaton, Ill. In September, it added a drive-through site in Bloomington, Ill. In addition to expanding testing availability, Test­Directly has decreased sharply the number of incoming calls about test results, Dr. Rossi says.

Bull, as well, reaped the rewards of fewer phone calls, despite Northwest Laboratory ramping up the amount of testing it provides thousands of miles away from Bellingham. The lab went from providing testing for 67 Florida counties through its contract with the state to also providing baseline testing for 140,000 employees at Florida’s registered long-term care facilities—stat.

Initially, Bull viewed the sudden shift in testing volume as a potential issue. “We can’t release results back to the employer directly; they have to go to the employee,” which requires a robust patient portal, she says. “So that’s when I called Suren and said, ‘Hey, can we make this happen?’”

In less than three weeks, LigoLab had TestDirectly up and running at the Bellingham lab. Specimens were shipped from testing sites via FedEx at the end of each day and arrived at the laboratory the next morning. The lab completed testing 24 hours from the time of receipt. Within two weeks, Northwest Laboratory had conducted baseline testing on all the long-term care facility employees and begun to test residents, eventually bringing the total number of tests to approximately 190,000.

While the long-term care facility employees registered for testing themselves and received results through the patient portal, facility administrators registered residents for testing and entered patient information into the portal on residents’ behalf. Results were communicated back to administrators through the portal and, in tandem, to the Florida Department of Health, which managed contact tracing and follow-up. The Florida Division of Emergency Management was also able to access TestDirectly to “see what was ordered, what was in processing, and what was completed so they could manage their results in real time,” Bull says.