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Accumen Launches Cloud-Based Network to Manage SARS-CoV-2 Test Capacity

NEW YORK – Healthcare consulting and lab optimization firm Accumen has developed a cloud-based network for helping hospitals and health systems report their SARS-CoV-2 testing capacity and route tests to providers with available capacity.

Launched by Accumen subsidiary Halfpenny Technologies, the system provides real-time data on SARS-CoV-2 testing availability, along with test order entry and routing, as well as delivery of test results to all parties that should receive them.

The system is part of Accumen's COVID-19 Resource Center, which the company announced the launch of on Wednesday. In addition to providing test management tools, the firm is also partnering with EnvisionTEC to provide 3D-printed testing swabs and with Technique Inc to provide face shields for health system staff.

Phoenix, Arizona-based Accumen is also collaborating with The Rockefeller Foundation to use the network to help with lab capacity and operability as the organization works to develop its testing-based plan to reopen the US economy.

The network links together test capacity, routing, and results information across the 870 hospitals in 48 states and 400 electronic health record systems that comprise Accumen's customer base.

"We're seeing two situations in the marketplace, hospitals and/or commercial labs that have ramped up [SARS-CoV-2 testing] capacity, and that capacity is being underutilized," said Charles Halfpenny, Accumen's chief technology officer. "And then we see hospitals and public health departments that are having challenges with capacity at the labs that they traditionally have relationships with."

He added that Accumen anticipated that as employers began to reopen businesses and city and county and state testing initiatives increased demand, test shortages could again become an issue in certain areas.

These testing challenges stem from issues like "a combination of capacity, of moving the data from a courier standpoint, getting information keyed in manually from order requisitions," Halfpenny said. "These are all factors that our core products have been solving for quite some time."

As Halfpenny suggested, the difficulties around SARS-CoV-2 testing have not been simply a straightforward matter of capacity. In fact, as of last week, a number of labs including some of the country's biggest reference labs, were operating below capacity for molecular SARS-CoV-2 testing.

Even providers in the same metro area may have difficulties coordinating testing to ensure patient needs are met with good turnaround time. For instance, Nathan Ledeboer, medical director of the microbiology laboratory at the Medical College of Wisconsin and Froedtert Hospital, noted that while his Milwaukee-area facility had in recent weeks been well below capacity for SARS-CoV-2 testing, another local provider had been struggling to get enough tests to expand testing to outpatient and ambulatory populations.

Accumen's experience in this area stems from its work helping hospital labs coordinate across systems to better compete with national labs, Halfpenny said.

"We help them deal with some of the challenges with their own registration systems – medical record systems, lab reporting – and we also give them the capability to move testing around between hospitals," he said. "In a group of three or four hospitals that would form to provide lab testing to their region, you might have one that becomes a center of excellence for cancer testing, another that does genetics, and then maybe the larger of the hospitals handles the majority of the tests, and then you're still sending some tests out to" Quest Diagnostics or Laboratory Corporation of America.

"We facilitate a lot of the routing of orders, making rules and decisions as to where orders should go and then also as the results come back … getting them unified and delivered to the right places," he said.

Halfpenny said Accumen began hearing several weeks ago of similar coordination challenges around SARS-CoV-2 testing, "and we started talking about how we might be able to tune our system to that."

Around the same time, one of the firm's clients, Chicago area-based, NorthShore University HealthSystem signed a deal to provide testing for a drive-through testing site the state of Illinois was launching in the area.

Halfpenny said that until the state got an order entry system up and running, NorthShore faced the challenge of having to deal with paper test orders and having to push the test results to Medicaid provider Centene, which was in charge of informing patients about their results.

Accumen worked with NorthShore to help move those results to the state and Centene, which led to discussions with several other hospitals in the area that were working to bring drive-through testing sites online.

"And that is when we realized that other regions were probably having similar challenges," Halfpenny said.

Additionally, an organization affiliated with The Rockefeller Foundation's COVID-19 efforts reached out to discuss how the company might help facilitate large-scale testing.

"Two of the elements they were looking at were being able to determine where to route an order based on capacity and based on turnaround time track record," he said. "We are seeing that capacity is fluctuating. [A lab] may have the platforms in place to do 500 tests a day, and they have an expectation of receiving a reagent order on Tuesday, but if it doesn't come that day, then their capacity may be impacted."

Participating hospitals provide daily updates on their SARS-CoV-2 testing capacity. Then as orders are placed, Accumen, through its network, checks what provider closest to the ordering site has capacity to fill the order.

If a lab has capacity, the company gives the go-ahead to that site to pick up the order. "And if that lab doesn't have capacity, then we will find the next closest lab that has capacity and a good record on turnaround time," Halfpenny said.

Accumen is also developing a portal through which organizations not part of its existing network can place test orders.The portal will give hospitals and labs information about where the test will be performed so that they can see the orders being routed to them in real time. They can then key that into their system before the specimen arrives.

Labs will be selected to fill orders not only based on current capacity but also on their record of turnaround time, which Halfpenny noted could promote more efficient distribution of orders by discouraging labs from holding onto test volume they aren't able to quickly process out of a desire to book revenue from those tests.

"There may be some organizations that would prefer to hang on to a test and not send it out even if it means a longer turnaround time," he said. "We are also using trailing five-day [records] of turnaround times as part of our algorithm that makes the decision of where to route something. So if that is a challenge for the lab, that they don't have great turnaround time, then they are not going to be selected by the algorithm."

Halfpenny said that while the network is currently focused on simply tracking test capacity, Accumen is also considering collecting data on the underlying reasons for gaps in capacity, which could provide potentially useful insights into supply chain issues with different test vendors.

Having that data could elucidate, for example, whether Abbott is doing better than Roche from a supply chain perspective, he said, adding "That is something to possibly layer on downstream if there is a lot of variability in capacity."

The network is primarily focused on molecular SARS-CoV-2 testing at this point, but Halfpenny said the platform is agnostic to the type of test being done and, so, could also be used for serology testing if that were to prove useful.

The goal, he said, was to keep testing within either a three-hour drive or three-hour flight of the ordering provider.

"Our true preference is to keep it all local so that it never gets on an airplane," he said. But at some point, because of a surge in cases in certain communities, or because they are just doing more testing, the tests may have to be sent to a facility further away, Halfpenny noted.