Another winter is quickly approaching, and Pharmacies have the opportunity to help their communities by becoming credentialed to provide CLIA-waived testing. As we already know, Pharmacies are the most accessible health care providers, with some patients already coming to us several times a month for prescriptions, over-the-counter medication, and vaccination needs. The next step is to provide point of care testing (POCT), whether for Flu and Strep or an entire testing suite. With that in mind and holidays approaching, this will be a short and sweet blog addressing POCT to detect viral or bacterial infections.

As stated in our previous blogs, Point of Care Testing in Pharmacy and Preparing Your Pharmacy for Point of Care Testing, the process of receiving your CLIA Certificate of Waiver and setting up your Pharmacy is relatively simple. It can be accomplished within a relatively short amount of time and a small amount of space in your Pharmacy – that you may already have set up for vaccinations and MTM services. But what is next? That depends on your plans and your State.

Perform the Patient Examination

What test(s) do you perform? When making this decision, you will need to look at the presented symptoms and determine what test(s) are appropriate. Beginning in 2021, you need to review patient symptoms and compare them with COVID-19. Group A Streptococcal (GAS) Pharyngitis symptoms and COVID-19 symptoms are very similar in some cases, meaning patients should be tested for both infections when possible.

Note: Always wear the appropriate Personal Protective Equipment (PPE) and adequately disinfect the patient area to prevent the transmission of infectious diseases.

Obtaining / Writing the Order

Some states will allow the Pharmacist to write an order for a Test. In contrast, other states will require a doctor (or other provider working on behalf of a doctor, such as a PA, Nurse Practitioner, or Pharmacist working under a collaborative practice agreement (CPA)).

Performing and Documenting the Test

Now it is time to obtain the specimen sample and run the POCT Test. This is simple enough. Document the patient’s consent for testing and follow your training on getting the sample and the instructions provided by the manufacturer to run the test. Always make sure to follow the most up-to-date instructions included in the actual test kit/cassette you are using since the manufacturer may occasionally update them. As the test is being performed, start writing up the testing documentation to go into the patient file, and prepare any notifications for the patient, their PCP, and your CPA physician partner. Once the test is complete, document the results and provide the notifications.

Note: Always wear the appropriate Personal Protective Equipment (PPE) and adequately disinfect the patient area to prevent the transmission of infectious diseases.

What now? The Patient is Positive.

Ok, so the patient tested positive for infection X. This is where things can get murky depending on your State. If the State permits, the Pharmacist could use the state guidelines or their CPA protocol to prescribe any medication permitted by the guidelines or CPA. Or, you may need to call the patient’s PCP and let them know of the results and request a prescription for the patient – in these events, it is always a good idea for the PCP to already be aware of the POCT services you are providing.

Billing the Patient and Insurances

If you have enrolled with insurance that will permit you to bill for a POCT test, make sure you follow any payer requirements. This may require you to perform and document a patient examination to validate why you are ordering and performing the test on the patient. If you are not billing insurances, collect the payment from the patient.

POCTTrack and COVID-19 and BLOODBORNE PATHOGEN EXPOSURE CONTROL PLAN

The POCTTrack program by PRS helps Pharmacies with the best practices and meeting any state requirements. The Program supplies you with the guidance, policies, procedures, and forms to set up the Pharmacy to provide Point of Care Testing. Additionally, the Program will provide the questions you need to ask the State Agency responsible for Clinical Laboratories and the State Board of Pharmacy related to state-specific rules.

The COVID-19 and Bloodborne Pathogen Exposure Control Plan by PRS helps Pharmacies meet OSHA’s Bloodborne Pathogen Standards. The Program supplies you with the guidance, policies, procedures, templates, forms, and employee training to ensure compliance.

Please give us a call at 1-800-338-3688 or visit our POCTTrack page and COVID-19 and Bloodborne Pathogen Exposure Control Plan page for more information.