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HealthTrackRx Investing in Rapid Turnaround Times to Drive PCR Infectious Disease Testing Business

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NEW YORK – While demand for COVID-19 molecular testing continues to decline, infectious disease diagnostics firm HealthTrackRx is betting that offering a rapid turnaround time will drive continued growth in its PCR testing business.

In November, the Denton, Texas-based company opened a high-throughput molecular testing facility near UPS's Louisville, Kentucky, hub that Executive Chairman and CEO Martin Price said will allow the company to deliver next-morning test results to customers anywhere in the country.

Founded in 2011, HealthTrackRx was originally focused on toxicology testing but shifted in 2018 to concentrate on PCR-based infectious disease and antimicrobial susceptibility testing (AST). Like many lab companies, it saw booming demand for its services during the COVID-19 pandemic and, Price said, has used both the revenues and experience gained throughout the pandemic to develop new systems and facilities to support the rapid test turnaround times that are key to its future business strategy.

HealthTrackRx offers a broad range of molecular infectious disease tests, but it aims to differentiate itself primarily through its combination of PCR-based testing and AST data and the shorter time to results (compared to conventional culture and susceptibility testing) enabled both by use of molecular testing and the company's logistics systems.

With an "antimicrobial stewardship program, if you don't intervene in the therapeutic decision early, your window shuts pretty fast," Price said. "Physicians may be willing to wait until the next day to get a result that will get their patient on the right antibiotic, but if you start stringing it out to three to four days, you've probably lost the opportunity to change therapy."

The decision to invest in the Louisville facility stemmed from a project launched in February at HealthTrackRx's Atlanta lab in which the company used a courier system to enable it to return test results the morning after samples were collected.

PCR infectious disease and AST assays generally take between six and 10 hours depending on the test, Price said. Typically, samples were collected from providers during the day and delivered to the company's lab the following morning. They were then run and results were sent out that evening. However, while this was technically "next-day service," in reality doctors weren't able to use results to guide patient treatment until the next morning, by which time it might have been nearly 48 hours since the sample was originally taken.

To address this limitation, HealthTrackRx used couriers throughout the Atlanta area to collect samples at the end of the day and bring them back to its lab where they could be run overnight and the results could be returned in the morning.

With that more rapid turnaround time, a doctor could see a patient and take a sample, give that patient an in-office antibiotic dose, and then get the test results the next morning that would allow them to select a therapy likely to work.

"We wanted to validate that next-morning results would be a market differentiator for physicians who were getting two- to three-day turnaround with their existing lab," Price said. "What we found was that there was enormous demand for those next-morning results. We exceeded our projections several-fold in terms of what we thought the demand would be. And in our conversations with physicians, it was clear that it really made an impact on their ability to get those results quickly to their patients and also to change therapy early."

With the Louisville facility, HealthTrackRx plans to take this approach nationwide.

Louisville is UPS's hub for its Next Day Air Delivery service, with most parcels delivered through that service passing through the hub. By setting up near the hub, HealthTrackRx is able to get quick access to samples from around the country.

"Every specimen goes to Louisville and gets delivered to us between 1 and 1:30 in the morning," Price said. "We are able to start running it in our Louisville lab around 2 a.m., and are now able to deliver that next-morning result to any patient and provider in the country who has access to UPS."

"That, for our business, is the difference between being able to deliver a result early the next morning as opposed to working doggedly to try to make a 5 p.m. or 6 p.m. cutoff," he said.

Urgent care centers comprise the largest portion of HealthTrackRx's business, with Price saying the company has worked to establish itself as "the go-to PCR lab" for these providers.

"Folks are going to urgent care because they don't want to wait three or four days to go to their primary care doctor, and in the same fashion they don't want to wait three or four days to get a lab result," he said. "So our value proposition ties in well with urgent care."

Price said the company's broad menu of infectious disease tests also fits well with urgent care centers, which see a wide range of infections and are attracted by the ability to send all of them to a single lab.

In a similar vein, pediatric centers and women's health groups are also important call points for the firm.

In general, the company is targeting places "with [a] high throughput of symptomatic patients, many of whom have some form of infection or suspicion of infection," Price explained.

With the opening of the Louisville facility, HealthTrackRx is considering pursuing the growing direct-to-consumer market, he said, noting that many pharmacy chains like Walgreens and CVS are serviced by UPS, making these stores potential drop sites for DTC testing specimens.

HealthTrackRx had shifted to focus on molecular infectious disease testing prior to the COVID-19 pandemic and, Price said, was initially "reluctant to turn the whole business upside down to chase" COVID-19 testing business. The company has done around 6 million SARS-CoV-2 tests since the beginning of the pandemic.

Price said the pandemic transformed both the logistics systems underlying HealthTrackRx's business and the lab industry more broadly.

He cited as one example the number of companies that have to help labs interface with various EMR systems to facilitate ordering and returning of results.

"There's a whole new cottage industry of companies that have come up just to help with [that]," he said.

He also noted improvements in the company's logistics operations and ability to track specimens from point to point. "That was accelerated for us during COVID, and I suspect it was for other labs as well," he said.

The company has also had to solve "how to deal with massive influxes of volume at once when you have 10,000 or 100,00 packages dropped at your loading dock in a day," he added. "We redesigned all of our labs … just to improve workflow and turnaround time. All the lessons of COVID are manifest in how we operate the lab today."

With COVID-19 volumes declining, Price said HealthTrackRx's main growth areas are respiratory viruses, urinary tract infections, sexually transmitted infections, and gastroenterological infections.

He noted that while a large number of molecular testing labs were established during the COVID-19 pandemic, this has had less of an impact on the company's business than he had expected. He suggested that because many of these labs were built specifically for COVID-19 testing, they didn't build out the revenue cycle and payor management systems labs need to be successful in a more traditional testing business.

"With COVID, you run a test and you get paid," he said. Whereas, post-COVID-19, "suddenly you are dealing with a really complex labyrinth of coverage policies and reimbursement schemes."

"In our experience, that has caused a lot of people who thought about getting into the PCR space to either close or go into something else," he said. "If you had asked me a year and a half ago, I would have expected a [more competitive] landscape, but it hasn't materialized."

Price declined to provide exact test volume numbers but said that, excluding COVID-19 testing, the company does several million tests per year and that over the last six months has received referrals from 10,000 unique providers. He said the company has roughly doubled the size of its non-COVID-19 testing business every year since it began focusing on infectious disease in 2018.