As COVID-19 spreads across the US, the digital health community has stepped up to solve urgent clinical needs, from providing free telemedicine visits to delivering in-home test kits.

Early on in the crisis, our team at Health Gorilla realized we had a significant role to play — 1,200 community providers and digital health organizations rely on us to place lab orders electronically and receive structured test results. We act as the API layer between 100 different labs and digital health developers, like Virta, DrChrono, and K health, whose provider users need the ability to monitor patient lab values. The vast majority of physicians who transact on our APIs are community-based providers, many of whom operate independent practices and are serving rural and suburban communities.

We moved quickly to launch COVID-19 test ordering and resulting in our system, starting with LabCorp on March 9th. The next day, we launched with Quest, and the day after that, BioReference went live. Together, these 3 labs make up a majority of the diagnostic testing market. Many other regional labs are now taking orders from us as well.

Now that physicians are getting results back through our system, we felt it was important to share some preliminary findings.

Over the past 2 weeks, Health Gorilla has processed 193 COVID-19 test results. The test could not be performed for 10 tests (5.2%). Of the 183 tests that could be performed, 8 tests (4.4%) were positive for COVID-19. The virus was not detected in 175 tests (95.6%).

Cumulative test volume is increasing exponentially among our provider base, as charted below.

We also were able to gather some data on test turnaround time, measuring the time from when the order was placed to when results were received. For LabCorp, it took roughly 98 hours on average to get results back. For BioReference, it took 46 hours on average. When looking across all the labs we transact with for COVID-19 tests, it took about 72 hours on average from order to result.

While the sample size is too small for making definitive conclusions, there are some key trends worth tracking.

1. Our positivity rate of 4.4% is lower than the 6–10% estimated positivity rate among those who are tested in the US. Our figures might be lower due to fewer cases in the rural or suburban community-based settings where most of our provider users are treating patients. As testing volumes increase, we may see positivity rates come down further.
2. About 5% of tests came back as TNP (test not performed), which is usually due to issues with the sample or how it was delivered to the lab. This requires another sample to be taken, delaying results by several days, leaving patients unsure about their status, and potentially spreading the virus to others. We recommend providers take a close look at sample requirements for the lab they’re working with to ensure the test is successfully performed. These requirements are changing frequently.
3. Most COVID-19 tests require a swab, not bloodwork, so labs are not collecting samples directly from patients. They require a physician to collect the specimen and send it to the lab for analysis. This poses a challenge for our telemedicine customers, where physicians are treating patients remotely and can’t collect a physical sample. We’re excited to see companies like Carbon Health working on in-home test kits so patients can consult with a physician and then collect and ship the specimen themselves if appropriate. This is an essential need for patients relying on virtual care.
4. There’s a general lack of standardization in ordering COVID-19 tests from lab to lab. Each lab has different requirements for collecting and shipping the sample. Time to receive results varies quite significantly. Some labs limit ordering to a few facilities, while some have expanded rapidly to run tests at many locations. As more test kits emerge, providers now see multiple order numbers for different COVID-19 tests and are unsure which test to order. This variability leaves providers confused, and as labs roll out new tests and requirements, we need to clearly communicate the implications of any changes to the ordering providers.

These are challenging times for almost every industry stakeholder. We are playing our part by helping providers place COVID-19 test orders without the administrative obstacles and getting them fast access to their patients’ test results. We stand in strong support of the medical providers serving patients on the front-lines of fighting this deadly virus. We’ve made lab ordering free for any provider looking to place COVID-19 test orders for their patients. Please get in touch with our team by submitting a message on our website, and we will get you up and running as fast as possible. We will be providing additional updates as more data comes in.

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To learn more about COVID-19 test ordering in Health Gorilla, see our press release. To get in touch, submit a message at healthgorilla.com.