Cole Diagnostics: On the Frontline and Helping Idaho Businesses Manage Their COVID-19 Testing Programs

Editor’s Note: This case study documents how Cole Diagnostics successfully supported its local business community with organizational direct-to-consumer lab testing for COVID-19 during the height of the pandemic. It was originally published on January 27, 2022. 

Built for Uncertainty: How Idaho Businesses Found Clarity Amid COVID Chaos

One of the most important lessons business leaders learned during the COVID pandemic is that progress can be undone in an instant. A new variant, sudden outbreak, or shifting policy can quickly reset even the best-laid plans. Navigating that level of uncertainty requires more than resilience; it demands a trusted, knowledgeable partner. For business leaders across Idaho, that partner has been Cole Diagnostics.

Facing the deadly Delta variant, the fast-spreading Omicron surge, and constantly evolving policies and protocols, Cole Diagnostics’ leadership recognized a common reality: many Idaho businesses were overwhelmed and searching for answers. With guidance and requirements changing by the week, confusion often outweighed clarity. To cut through the confusion, employers partnered with Cole, an independent, full-service medical laboratory known widely for its proactive, consultative guidance on COVID-19 testing mandates and compliance, helping organizations make informed decisions and move forward with confidence.

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Mandate or Not, the Rules Are Still in Play

“There is a lot of confusion within the business community right now,” said Richard Hughes, Director of Laboratory Sales & Marketing at Cole Diagnostics. “Many employers assume vaccine-or-test policies are off the table because the Supreme Court blocked the federal mandate for large employers. That’s partially true. What remains, however, is the authority of states and individual employers to require proof of vaccination or a negative COVID-19 test as a condition of coming to work.”

Earlier this year, the Occupational Safety and Health Administration (OSHA) proposed a requirement for private companies with 100 or more employees to implement weekly COVID-19 testing and masking for unvaccinated workers as a means to increase vaccination rates. While the Supreme Court blocked that federal employer mandate on January 13, the decision did not eliminate state-level or employer-driven vaccine-or-test policies. As a result, millions of workers are still expected to be affected, and laboratory industry experts anticipate COVID-19 testing volumes will surge to levels not seen in months.

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Prepared, Proactive, and Ready to Partner

“Businesses should still develop a plan for potential testing programs,” added Hughes. “We have the staff, capacity, and technology to support them. Most importantly, our role is to educate the community, provide peace of mind, and make it clear that we’re ready to step in as a trusted partner.”

By partnering with Cole Diagnostics, Idaho businesses gain both experience and flexibility. To better support employers and community partners, the progressive organization has invested in advanced laboratory information system (LIS) software technology that streamlines and customizes direct-to-consumer lab testing programs based on each organization’s size, location, and specific requirements. This high level of adaptability enables Cole Diagnostics to differentiate itself from competitors, delivering tailored solutions instead of one-size-fits-all testing models.

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Remote Testing Made Simple with TestDirectly

“In many cases, we can leverage TestDirectly to help businesses manage their testing programs remotely,” explained Hughes. “Employees simply visit the TestDirectly web portal, schedule an appointment, and come into our lab for testing. Employers can then securely access test results through the portal, making compliance tracking and reporting far more efficient.”

TestDirectly is an intuitive direct-to-consumer lab testing portal that enables clinical laboratories to eliminate intermediaries and deliver turnkey, point-of-care testing solutions for both patients and employers. Through advanced automation, the platform creates direct-to-consumer labs by eliminating common laboratory bottlenecks and streamlining specimen collection and processing, accelerating result delivery, simplifying payment and compliance management, and enabling real-time monitoring and tracking of test results. All this provides a smoother, more convenient patient experience.

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Turning Complex Testing Programs into Turnkey Operations

TestDirectly saves laboratories and employers valuable time and resources by eliminating paper forms and manual workflows that slow operations down. Instead, it delivers end-to-end efficiencies, starting with patient self-registration and extending through automated test result notifications. The online portal also provides robust access controls, enabling administrators to view results by location, employee, or other defined attributes, while automatically reporting results to public health departments and other required stakeholders.

“Whether you’re a laboratory information system manager or an employer, standing up a large-scale, direct-to-consumer lab testing program from scratch is incredibly challenging and resource-intensive,” said Suren Avunjian, CEO of LigoLab. “With TestDirectly, we deliver a proven, turnkey testing solution, backed by a trusted network of direct-to-consumer labs like Cole Diagnostics that have processed more than 15 million COVID tests during the pandemic. Together, they can quickly become the foundation of any organization’s testing strategy.”

Scaling Smart: Efficiency and Agility in a High-Demand Testing Environment

Efficiency and agility will be critical for laboratories working to scale operations amid rising testing volumes. Labs must expand capacity without compromising turnaround times, and employers need a cost-effective, fully integrated LIS system software and direct-to-consumer lab testing solution to track and manage employee health status, particularly if they move forward with serial testing programs for unvaccinated staff.

To meet these demands, Cole Diagnostics offers employers a wide range of flexible options, helping them design and implement direct-to-consumer lab testing programs tailored to their specific business needs, workforce size, and operational requirements.

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Flexible Testing Options That Meet Businesses Where They Are

In addition to in-lab and drive-through direct-to-consumer lab testing at its Garden City location, Cole Diagnostics also offers on-site testing services tailored to the needs of the business community.

“We’re positioning ourselves to support pop-up, onsite testing programs,” said Eida DeLeon Siegel, Client Services Manager at Cole Diagnostics. “On-site testing events are ideal for employers with 50 or more employees who need to test unvaccinated staff. We can even deploy rapid antibody testing, allowing employers or shift supervisors to quickly determine whether someone may pose a risk before entering the workplace.”

Scaling Capacity Without Sacrificing Speed or Quality

Cole Diagnostics is actively preparing to adjust its operations to meet demand. The laboratory plans to expand capacity by adding additional shifts, as a COVID-19 surge typically reduces testing tied to non-emergency medical procedures. This shift naturally frees up even more capacity for COVID-19 testing, without the need to hire additional staff.

“The current demand for PCR testing is around 800 to 1,000 tests per day,” explained Hughes. “To scale beyond that, we would add around-the-clock shifts, which would allow us to run more than 2,000 individual PCR tests per day.”

If demand exceeds those levels, Cole Diagnostics can implement pooled testing strategies. In this model, four or five samples are combined into a single tube. If the pooled sample tests negative, all individuals are cleared. If it tests positive, each specimen is then run individually in a follow-up test. This approach is especially effective when positivity rates are low, enabling the lab to increase total daily capacity to 5,000 tests or more.

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Choosing the Right Test: Flexibility with Clinical Insight

When asked how Cole Diagnostics advises employers on selecting the appropriate COVID-19 test, Siegel emphasized that the decision ultimately comes down to employer preference and operational needs.

“Some employers may prefer PCR testing, while others opt for rapid antigen tests,” she said. “We’re prepared to support either approach based on what a business decides to require. The OSHA mandate itself didn’t specify a test type, only that the test be FDA-approved or authorized for emergency use.”

That flexibility, however, comes with an important clinical consideration.
“When using rapid antigen tests, a negative result for someone who is symptomatic must be confirmed with a PCR test,” added Hughes. “There’s also a risk of false negatives in asymptomatic individuals if testing occurs early in the transmission window. Antigen tests are the most cost-effective way to screen large groups quickly, and then any positive results can be confirmed with PCR testing to ensure accuracy.”

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Testing Still Matters: Protecting Employees, Customers, and Communities

When asked whether they had advice for employers considering direct-to-consumer lab testing programs, Hughes and Siegel were aligned. Despite the federal mandate being struck down, they believe testing remains a best practice, especially for businesses whose employees regularly interact with customers.

They point to BMC, a regional building materials and construction company, as a strong example for other Idaho businesses to follow. Early last summer, BMC leadership recognized that sending crews into homes and job sites without testing posed unnecessary risk. To safeguard customers and the community, the company partnered with Cole Diagnostics to implement routine COVID-19 testing, ensuring employees were not unknowingly bringing the virus into customers’ homes.

Even Vaccinated Workforces Benefit from Regular Testing

But what if every employee is already fully vaccinated? According to Hughes, testing should remain part of an employer’s COVID-19 strategy.

“The reality is that vaccinated individuals can still contract and transmit the virus,” said Hughes. “Regular testing helps slow the spread of COVID-19 and protects vulnerable members of the community, which is why it makes sense to include everyone.”

Siegel added that employers may be able to offer testing through an employee assistance program (EAP), a benefit designed to support employees with personal or work-related challenges that affect performance, health, or well-being. She noted that businesses should consult legal counsel to understand how testing could be structured within an EAP framework.

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Behind the Scenes to the Front Lines

Cole Diagnostics is a comprehensive, reference laboratory specializing in pathology, cytology, molecular, microbiology, clinical chemistry, immunoassay, tissue staining, and more. The lab processes roughly 80 percent of what any physician could want or need beyond genetic testing and gene sequencing. As such, the team usually operates in the background, but that changed when the pandemic became a reality. That’s when they put themselves on the front lines to help the community.

“In the first year of the pandemic, we went around the clock,” added Hughes. “The team became forward-facing frontline responders during the pandemic. I am proud of the team’s resilience and dedication to each other, the company, and the community. It was a challenging time, but we found a way to get it all done, and that’s how we’ll continue to operate.” 

Rest assured, when businesses turn to Cole Diagnostics, the dedicated team of lab professionals will put the full force of its knowledge, dedication, and flexibility to work on their behalf.

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