By Mehdi Maghsoodnia
The COVID-19 testing crisis has exposed what a disaster our gridlocked, patchwork healthcare system is in the United States. We operate with a medical system that is complex and siloed, with huge difficulty communicating among different groups. This is evident in the way patients have been receiving delayed, incorrect test results throughout the pandemic. And processes used around the world for testing are equally outdated: just recently, England misreported 16,000 cases of COVID due to a spreadsheet error.
But issues with testing have been around far before COVID-19. If you’ve ever gotten bloodwork (or any lab work) done, you know that our current lab process is clunky to say the least. To get a test, you have to jump through hoops and get approval or input from individual doctors, hospitals, and labs. Not all of these are always connected. On top of that, once the test is done, the information tends to flow to systems that are closed and disconnected. Your tests results come from the lab, and end up in Electronic Health Record (EHR) systems that often share the data as a static PDF report—or raw data with zero patient-friendly explanation. Interpretation and deep analytics just don’t exist in our testing systems today. In the middle of a pandemic, states are asking each lab to send them information through spreadsheets and shared online drives.
As a patient, it’s difficult to get clear test results, which can make or break your health plan. As a doctor, it’s tricky to route requests to the right labs and insurers. And as a lab, it’s overwhelming to deal with requests without a centralized dashboard. Nobody wins in our current system. It does not help that our payment and regulatory framework also supports a fragmented model.
I firmly believe that the testing doesn’t have to be stuck in the past—relying on manual inputs, spreadsheets, and illegible PDFs just doesn’t cut it anymore. What if there was a software that made it easy for patients, providers, and labs to get testing done? What if the same software routed tests to the most readily available labs, instead of just the big names that are already overloaded with requests? And what if the tests conveniently came to the patient’s home, with easy-to-read results later on? This system already exists. It not only provides simple ordering and logistics, but at-home testing, and clear, actionable results for providers and patients, along with deep analytics.
This is what I call Testing as a Service (TaaS). It may sound complex, but we have experienced Software as a Service (SaaS) in other industries. For example, we are used to Airbnb which took a fragmented market of home rentals and made it simple. Instead of each person searching for a home, negotiating a rental agreement and payment on their own, Airbnb makes the process simple and scalable. Similarly, if you want to get a ride from Uber, you go into the app and select whether you want a big car, luxury car, group car, or so on. TaaS does the same thing for medical testing. You go in, and it presents options for the kinds of tests, collection methods, and so on. Just like on Airbnb, where you don’t worry about calling up and negotiating with every homeowner, TaaS also allows for simple transactions between providers and labs. A physician can send you a COVID-19 test at home without having to worry about lab contracts, turn around times, shipment, insurance payment and more. We have this software cloud service already working in the US—our problem is bringing awareness and overcoming regulations that prevent the adoption of Taas platforms.
The experience on a TaaS platform is much simpler, whether you are a patient, lab, or provider. Labs can easily sign up new healthcare providers and systems without having to worry about contract negotiation, reporting, and payment. A physician can order a test without thinking about whether the test has been shipped to Kentucky, New Jersey, or Washington. Results get reported to the physician, federal government, or state agencies seamlessly. The patient receives their results in a modern online platform that provides rich content and information, allowing them to understand what the test results actually mean and what they should do about it.
As a lab, company, or provider, if you want to use Testing as a Service, you don’t have to write any custom code, or do any custom contracts — the complexity is handled for you. You get a consolidated dashboard with all reporting and performance. More importantly, it’s also the single platform that handles analytics. On it, you can see (for example) the positive trend of COVID-19 testing over time, isolate it by ZIP code, or search by age. There has never been a central platform to do this with testing before.
The innovation of TaaS has the potential to make testing affordable, easy and safe for everyone. The following are some of the benefits of adopting a Taas approach:
- Labs that have capacity in other states can provide their services to anyone client in any state without having to negotiate contracts, do customer integration or worry about getting paid. This will reduce the need for building labs in states that have limited funding.
- Physicians in remote areas can get access to lab services that are only today available in urban areas or high income neighborhoods.
- Consumers can get the most affordable, high quality test regardless of their zip code and insurance type.
In order to make this a reality, we have to make sure our government officials understand this technology trend and do not write regulatory laws that restrict the adoption of these smart software platforms. We are seeing attempts at the regulatory level similar to what taxi companies did with Uber and Lyft trying to prevent competition in their local markets. This type of regulatory protection will force physician and hospital systems to adopt testing solutions that are expensive, slow and difficult to adopt. We need to adopt modern software solution like TaaS in the healthcare market that drive down cost, are easier to deploy and use and improve customer experience and outcomes.
Mehdi Maghsoodnia is CEO of 1Health, the company that pioneered the first self-administered COVID-19 saliva test that was authorized by the FDA under EUA earlier this year.