Drive-Through Medicine: A Novel Health Care Delivery Mechanism for the COVID-19 Pandemic

Abstract

BackgroundCoronavirus disease 2019 (COVID-19) placed additional strain on an already struggling health care system. In response, novel solutions such as telehealth have been explored, however, there is significant room for innovation in health care delivery. ObjectivesThe aim of our study was to evaluate the effectiveness of a drive-through medical treatment system for evaluating patients with COVID-like symptoms. MethodsWe designed a prototype drive-through medical treatment facility (DMF) to triage large volumes of patients quickly and efficiently, while fully evaluating, treating, and discharging low-risk patients. A retrospective chart review was performed to extract clinical and logistical metrics. ResultsA total of 2164 patients were evaluated between May 1 and July 1, 2020. Overall accuracy for patient classification was 92.4% (95% confidence interval [CI] 91.2–93.5%). Screening criteria resulted in a return with need for workup or admission rate of 0.25%, yielding a sensitivity of 83.3% (95% CI 65.3–94.4%). Of those presenting to the DMF, 179 patients (8.3%) were diverted to the main emergency department (ED) for further evaluation, of which 14% received diagnostic workups and 5% subsequent admission to an inpatient service, yielding a specificity of 92.8% (95% CI 91.7– 93.9%). Length of stays for those seen in the DMF vs. the main ED (M = 38 min vs 149 min) yielded a mean difference of 111 min per encounter and a total time savings of 3762 h. ConclusionDrive-through medical systems can accurately triage patients presenting with potential COVID-19 and effectively treat lower-risk patients, thereby reducing ED utilization.