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Starting & Scaling COVID-19 Testing – The Experience of Los Angeles County

by Kiran Ganda | July 22, 2020 | Blog, Molecular News, What’s New

On July 22, Sunquest sponsored a lively and timely webinar, hosted by the Dark Report, featuring speakers from the Los Angeles (LA) County Department of Public Health – one of, if not the hardest-hit counties –– by COVID-19 in the United States. Specifically, Dr. Nicole M. Green, PhD, D(ABMM), Director of the Los Angeles County Public Health Laboratories, and Mr. Ashutosh Ruparelia, MT (ASCP), CLS, Information Technology Manager at the laboratories, detailed their first-hand, front-line experience with the COVID-19 pandemic, including starting and ramping up testing, complying with changing regulations, selecting lab automation technology, and lessons learned from the still-evolving experience.

Let’s review the questions raised to Dr. Green and Mr. Ruparelia on July 22, along with summations of their responses.

Sunquest: Please could you give the group an introduction to your laboratory?

LA County: Our lab is one of 30 local public health labs in California, and the largest in California. It is also one of the largest in the nation next to labs in New York City. We are a full-service microbiology lab, serving a population of more than 10 million people, and are considered the reference lab not only for Los Angeles county, but also for the city of Pasadena. We participate in a variety of state, national, and global laboratory networks and perform approximately 600,000 tests annually on human, animal, and environmental specimen types. Our patient population comes from across 14 county clinics, more than 100 public and private hospitals, community-based providers, commercial reference labs, and also public health program investigations, outreach testing, and surge-support for other local California public health labs and state laboratories on the west coast.

Sunquest: Tell us what happened when COVID-19 hit. What kinds of challenges did you face as the pandemic continued?

About the author
Kiran Ganda Director of Product Marketing
Kiran Ganda
Director of Product Marketing, Precision Medicine

Having worked exclusively in health technology organizations for more than fifteen years, Kiran is passionate about innovations in patient care.

LA County: Initially, when COVID-19 hit, everything was manual. There was no client or instrument interfacing and we were facing erratic volumes, all types of customers, and lots of pre- and post-analytical work due to the lack of automation. Because of all of this, there was a huge staffing effort – we had more than 10 staff assigned to do order entry, accession specimens, and check data entry. Then we had a team of 15 performing analytical testing. Quickly, test volumes started to go up, and it became a challenge to get results back rapidly to ordering facilities. We quickly assigned 2-3 people daily to print, fax, and email results. As volume growth continued, we implemented faster processes as well as higher throughput tests. We added additional shifts and days that the lab operated and began experimenting with new workflows and adding additional equipment. A few months in, we also diversified our test types, to include rapid molecular testing and serology.

Early on, we realized that full automation was going to be necessary, given the expectation that we would be processing a minimum of 1,000 samples per day. The challenges of not having automation were many – delays in reporting and turnaround time, incomplete test requisitions (which led to manual clean-up and phone calls), and of course the strain on our staff. We needed to have backup for all of our testing – both molecular and serological, needed to get them into our LIS, and needed to get results and reports to clients quickly for infection control and contact tracing. On top of that, there were the ever-evolving federal and state reporting requirements, including the considerable amount of data fields outlined in the 2020 CARES Act.

In the past, every time an outbreak had happened, whether measles, mumps, or the Zika virus, we had said we needed to automate. COVID-19 was definitely our turning point. During each wave of challenges that the pandemic brought – whether exploding order volume, cleaning up test orders, trying to deliver timely results, or adhering to changing and more complex reporting regulations – each was another piece of evidence that we needed to have electronic orders and results.

Sunquest: What do you hope to achieve with the Sunquest Physician Portal for COVID-19, aside from the obvious management of order volume and results delivery and reporting?

LA County: We expect that by streamlining and automating orders and results processes for COVID-19, it will free up time for other diagnostic testing work which is starting to come back now. The strain on our staff should be markedly reduced. Other benefits we expect to see are rejecting fewer tests, attracting more customers, and continuing to elevate our brand reputation as a quality leader for lab testing in the Los Angeles area. With the portal up and running, we also hope to help more labs when their regional areas are experiencing surges or when specimens get re-routed. When COVID-19 activity calms down, we want to expand the portal to all of our communicable disease tests that we offer to clients who are not interfaced.

Sunquest: Final thoughts or lessons learned that you would like to share with the audience?

LA County: Yes – do not wait to automate! There is never going to be a better time, or enough staff, or a bigger outbreak, or a larger patient need. The time is now. Using technology to drive orders and results efficiency is critical to addressing the pain points labs face under a variety of circumstances – when orders are surging, when resulting and reporting requirements are changing, when data needs are complex, when staff is strained – so many reasons for labs to just do this sooner rather than later. Implementing the portal has also delighted our clients – they love the idea of being able to access it anytime, anywhere for round-the-clock connectivity to us.

To view the full Dark Report webinar, sponsored by Sunquest, please click here.

From testing execution support, to orders and results automation, to reporting, to broader-scale disease surveillance, tracking, and tracing capabilities, and more, Sunquest is proud to offer resources for COVID-19 across the spectrum of the laboratory workflow. For a complete list of solutions available to support COVID-19, including the Sunquest Physician Portal and the Sunquest COVID-19 Essential Suite, click here.

About the author
Kiran Ganda Director of Product Marketing
Kiran Ganda
Director of Product Marketing, Precision Medicine

Having worked exclusively in health technology organizations for more than fifteen years, Kiran is passionate about innovations in patient care.

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