In the battle against COVID-19, speed matters. Rapid testing helps improve the timeliness and accuracy of case counts, which informs the actions of individuals, businesses and governments. Health care providers worldwide have turned their focus to optimizing care delivery while ensuring results get to community members and patients as quickly as possible.
When Victoria, Australia's Alfred Health began testing patients for the virus in March 2020, leaders knew reference labs’ three- to five-day result turnaround time wasn’t fast enough. They acquired a new laboratory analyzer device to accommodate higher testing volumes and get results to patients and decision-makers faster.
"We typically process a test and share results with the patient in less than 24 hours. The quick turnaround, particularly with the use of automatic text message, allows faster assurance for patients."
- Jeffrey Box, team lead and business analyst, pathology IT, Alfred Health
Alfred Health’s leaders approached their Cerner contacts to begin preparing for the device's April arrival. The Cerner team quickly upgraded Alfred Health's device connectivity infrastructure with a new CareAware iBus® server, which enables plug-and-play connectivity between devices and the electronic health record (EHR). The teams also prepared Alfred's EHR to interface with the new device by pre-installing a driver for the analyzer.
"There were so many moving parts that needed to be pulled together quickly," said Jeffrey Box, team lead and business analyst, pathology IT. "Everyone fast-tracked normal processes to be ready in a few weeks. Ordinarily, it would have taken three to six months."
Now, COVID-19 testing orders flow directly to the new analyzer. After tests are processed, negative results bypass the laboratory review queue and are immediately available within patient records. Alfred Health staff configured Discern® rules within Cerner Millennium® to automatically interpret positive test results, allowing laboratory staff to quickly validate results and release them to patient records with minimal delay.
The process frees staff to focus on preparing samples for testing rather than reporting and verifying test results. Patients who test negative for the virus receive an automatic SMS text message with their results. Positive results trigger an email to relevant medical staff, who quickly notify the patient and reporting authorities.
"We typically process a test and share results with the patient in less than 24 hours," said Box. "The quick turnaround, particularly with the use of automatic text message, allows faster assurance for patients."
Rapid turnaround also helps Alfred Health use resources — like patient isolation spaces, personal protective equipment and staff — judiciously. Negative test results allow staff to move acute patients out of COVID-19 precautions sooner. And for Alfred Health staff who have been furloughed or in isolation due to COVID-19 precautions, negative results are a ticket back to work.
Quickly identifying COVID-19-positive patients also supports broader efforts to contain the virus through contact tracing. "Testing samples rapidly helps ensure that those who test positive for COVID-19 are isolated quickly, and any contacts are traced," said Box.
Alfred Health supports Victoria’s COVID-19 monitoring efforts by uploading daily data extracts to the state’s Department of Health Communicable Diseases Data Hub.
"We’ve created customized reports using Cerner Command Language to generate extracts with the exact information requested by Victoria's Department of Health and Human Services, rather than fixed fields," explained Box.
Australian leaders use that information to inform their plans for combatting COVID-19 with individual mandates as well as business and border closures. In response to rising COVID-19 case counts in early July 2020, Victoria's government implemented a six-week return to stay-at-home restrictions for metropolitan Melbourne and Mitchell Shire. From the heart of that region, Alfred Health's laboratory staff feel prepared to accommodate a rising need for testing.
"The instrument and associated IT package have allowed us to more easily cope with fluctuations in test numbers without a huge impact on staff requirements," said Box. "Sincere thanks to all involved with enabling Alfred to provide the care and confidence required for so many patients."
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