Developing sustainable workflows for community pharmacy–based SARS-CoV-2 testing

Abstract

BackgroundThe coronavirus disease Rapid Antigen Testing Expansion Program (Program) employed a drive-thru model to maximize pharmacy staff and the public’s safety. ObjectivesTo quickly design, implement, and disseminate a pharmacy-based point-of-care testing program during a public health crisis. Practice descriptionCommunity pharmacies in Idaho were engaged in the state’s public health efforts to boost severe acute respiratory syndrome coronavirus 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 innovationProgram 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 methodsTesting data (pharmacy location, patient insurance status, test type and results, number of submitted Medicaid claims) were captured in an online form. ResultsFrom September to December 2020, 13 pharmacies opted into a drive-thru, rapid antigen point-of-care testing and nasal swab for offsite testing program. A total of 2425 tests were performed. Approximately 29.4% of point-of-care tests were positive, and 70.6% required backup polymerase chain reaction 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/day and 2.6 days/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. ConclusionIndependent community-based pharmacies should be considered as partners in public health initiatives.