Developing Sustainable Workflows for Community-Pharmacy Based SARS-CoV-2 Testing

O’Connor, Shanna K.; Healey, Patricia; Mark, Nicole; Adams, Jennifer L.; Robinson, Renee; Nguyen, Elaine

Background The COVID-19 Rapid Antigen Testing Expansion Program (Program) employed a drive-thru model to maximize pharmacy staff and the public’s safety. Objectives To quickly design, implement, and disseminate a pharmacy-based point-of-care testing program during a public health crisis Practice Description Community pharmacies in Idaho were engaged in the state’s public health efforts to boost SARS-CoV-2 testing statewide. Geographic location was a major recruitment factor. Two recruitment periods were held to extend the Program’s reach into more remote underserved communities. Practice Innovation Program and pharmacy staff developed workflows and materials in an iterative process. Pharmacies received testing supplies. Program staff created e-Care plans for documentation and reimbursement and designed a web portal for state reporting of positive rapid antigen test results. Evaluation Methods Testing data (pharmacy location, patient insurance status, test type and results, number of submitted Medicaid claims) were captured in an online form. Results From September to December 2020, 13 pharmacies opted into a drive-thru, rapid antigen point-of-care testing and nasal swab for off-site testing program. A total of 2,425 tests were performed. Approximately 29.4% of point-of-care tests were positive and 70.6% required backup PCR confirmatory analysis. Patient insurance breakdown was 72.1% private, 8% Medicare, 11.4% Medicaid, and 8.5% uninsured. On average, pharmacies tested patients an average of 2.3 hours per day, and 2.6 days per week. As a group, they provided 77.5 hours of testing per week statewide. Program pharmacies accounted for an average of 5.1% of testing across the entire state at the end of December 2020. Conclusion Independent community-based pharmacies should be considered as partners in public health initiatives.