Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to "Keep" Your Lab.

Paczos, Tamera A

Context: Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services which can jeopardize a hospital systems ability to respond to a health care crisis. Objectives: To demonstrate investment in a core laboratory serving an academic medical center equipped a regional health system to respond to the pandemic. Design: COVID-19 diagnostic testing data was analyzed. Volumes were evaluated by result date (3/16/2020 - 5/6/2020) and the average of received to verified turn-around-time (TAT) was calculated and compared for in-house and send-out testing, and different in-house testing methodologies. Results: Daily viral diagnostic testing capacity increased by greater than 3000 % (from 21 tests per day to 658 tests per day). Total viral diagnostic testing resulted by the core lab increased by 128 times over 22 days of test method validation and 826 times over the analysis period while average turn-around-time per day for send-out testing increased from 3.7 days to 21 days. Decreased overall average TAT was observed at the core laboratory (0.45 days) verses send-out testing (7.63 days) (P < .001). Conclusions: Investment in a core laboratory provided the health system with the necessary expertise and resources to mount a robust response to the pandemic. Local access to testing allowed rapid triage of patients and conservation of scarce personal protective equipment. In addition, the core laboratory was able to support regional health departments and several hospitals outside of the system.