Building Testing Programs in a Pandemic: Traditional v. Nomi

The COVID-19 pandemic has laid bare the glaring flaws in our healthcare system. For one — it has become even more evident that healthcare in the U.S. is unnecessarily expensive and complex. Most medical care costs in the U.S. are double or triple what it is in other countries. When it comes to COVID-19 testing, in recent months some providers have charged up to $2,315 for a single test.

We founded Nomi Health with the belief that if we streamline healthcare processes, we can dramatically cut costs and increase access. Healthcare is expensive and complex, but it doesn’t have to be. The same applies to COVID-19 testing.

In order to get through this pandemic, we cannot rely on the stale traditional approach to testing for a virus. We need to build, as we have over the last few months, a testing program from the ground up that:

  1. Uses technology
  2. Creates a seamless user experience
  3. Delivers results quickly
  4. Captures and digitally records data at each step to make quality control and public health decisions easier
  5. Doesn’t incentivize overbilling and running up costs

It also requires a single contractor to manage the program and coordinate logistics, rather than paying and managing dozens of individual companies.

User experience

Testing programs that are reliant on traditional healthcare methods, which we are seeing at scale (and fail) across the country, are not built with the patient or public health goals in mind. From the patient perspective — traditional testing programs are difficult to navigate and create unnecessary headaches.

For most traditional testing programs — the process starts by making the patient call a number and wait on hold until a person can give them a quick assessment to see if they qualify for a test. If the patient is deemed appropriate to qualify, they are given a testing location but no appointment. Most patients are left waiting in line for hours before getting swabbed.

Compare this to the Nomi approach where we start with an online assessment. Patients can take the online assessment on their own time and quickly schedule an appointment that works for their schedule if they are deemed eligible. This simple scheduling feature allows for patients to arrive at a testing location and get swabbed immediately rather than needlessly waiting in line for hours. Each patient also received a unique barcode so we can track their appointment, sample and results.

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Getting results quickly

Another important feature of a successful COVID-19 testing program is the ability to deliver results quickly. Patients are putting their lives, and often their families’ lives, on hold while they wait for results. Not only is this frustrating for patients, it’s even more frustrating for public officials that need an immediate read on the impact of COVID in their communities. The reality is that our lives will be dictated by cycles of testing from now until there is a widely available vaccine for this virus.

Right now, the majority of testing programs take multiple days to turn around a test result. Even worse, some programs don’t even notify patients if their results come back negative. They are just left to assume that they don’t have the virus. This is distressing and unhelpful. At Nomi, our testing programs deliver results within an average of 24–48 hours and we will always notify patients of their results, even if the result is negative.

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Digital records = quality control

Quality control is at the heart of any successful testing program. COVID testing is still new and we are constantly learning what works well and what does not on a daily basis. Our testing programs are designed to digitally capture data at each step of the testing process so that we, in coordination with our partners, can ensure that everything is working correctly and efficiently.

For example, our programs record and report back key metrics from the very first time a patient visits one of our testing websites to the moment they get their final test results. If there are aberrations or anomalies, we can work with our government partners to address them in real time. Traditional testing programs are unable to record this info as they rely heavily on analog technologies like phone assessments. Without a digital record, it is impossible to conduct the quality control necessary. Capturing data also allows public health officials to identify trends and enables us to quickly move testing sites to where they are needed most.

Keeping costs in check

As we mentioned at the top, certain COVIDtesting providers have seen this pandemic as a golden opportunity to overbill governments and insurers. Our model helps disincentivize runaway costs and overbilling by positioning us as the general contractor.

Our government partners come to us with a budget and we take that budget and look for opportunities to create efficiencies in the supply chain without sacrificing quality to lower costs. In Utah, we are able to provide a holistic testing solution — everything from assessment to test kits to customer service — for roughly $122 per test. Every day we work hard to bring those costs down and find efficiencies where we can.

This approach works

Our response has been unconventional, but it has worked and been widely effective. To date, we’ve helped mobilize 30 testing sites across three states, completed over one million online assessments and account for 3% of all COVID tests done in the U.S.

Every public health expert says we need widespread testing to get the country back up and running. If we want to do that, we have to streamline the testing process.

Since the start of our testing problems there hasn’t been a lack of clinical expertise, there’s been a lack of process to get it right. There’s a way to test populations at scale and cut costs. We’ve done it and it’s time for more programs to follow our lead.

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Healthcare is expensive and complex, but it doesn’t have to be. We are working to streamline healthcare processes and increase access.

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