Remembering COVID: How the Washington State Department of Corrections Manages its COVID-19 Organizational Testing Program

Editor’s Note: On May 11, 2023, the World Health Organization officially declared the end of the global COVID-19 Public Health Emergency. As life gradually returns to normal, many have begun to move past the challenges of the pandemic. However, for those in the healthcare industry, particularly in laboratory information and laboratory workflow management, it's crucial to pause, reflect, and apply the hard-earned lessons to prepare for future infectious disease threats.

Learn More: End of the Federal COVID-19 Public Health Emergency (PHE) Declaration

At LigoLab, supporting our lab partners through the pandemic was a top priority. We worked tirelessly to understand their evolving needs and provided innovative LIS laboratory information system software solutions to help them navigate the unprecedented challenges posed by COVID-19. From rapidly implementing new laboratory information system functions and clinical lab workflow to prioritizing patient and provider safety, our efforts were guided by collaboration and a shared mission.

A highlight of this journey was capturing stories of resilience from our partners on the frontlines. With that in mind, let's take a moment to remember and review the following case study, first published on June 1, 2021.

Direct-to-Consumer Lab Testing Challenges and Success: Highlighting the Washington State Department of Corrections' Organizational Testing Program

Meet Jeremy Turner, Correctional Program Manager 

It goes without saying, but Jeremy Turner and his colleagues at the Washington State Department of Corrections have unique and challenging jobs. Turner, a 22-year veteran of the DOC system, is a Correctional Program Manager. He's charged with maintaining safety and security for 2,500 incarcerated individuals at Coyote Ridge Corrections Center, a medium-security prison located in Connell, Washington.

Over his many years of service, Turner has witnessed riots and food strikes on the job. He said things of this nature come with the territory and that he and his colleagues are trained to handle them.

A New Kind of Challenge: Leading COVID-19 Testing Statewide

That training has also served Turner well since June of 2020, when the DOC began serial testing of staff and large-scale testing of incarcerated individuals for COVID-19. Turner continues to play a lead role working with DOC headquarters to oversee COVID-19 management and testing at all 24 facilities that comprise the system.

"We've faced a lot, but this is a completely different animal that's affected everybody in a much more personal way," he said. "You feel it at work, and you feel it at home."

Early Days of Testing and Using a Complicated System

During those early days of testing in June of 2020, the DOC was tasked with using a complex system for its COVID-19 management. The system wasn't very adaptable to their needs, especially when attempting to set up recurring orders for recurring tests. 

That changed about a month later when the DOC, following the direction of the Washington Department of Health (DOH), began a working relationship with Northwest Laboratory (now known as Avero Diagnostics). That's when the TestDirectly Direct-to-Consumer Lab Testing and Patient Engagement Portal was first introduced to Turner and his team.

"Once we started using the TestDirectly platform, we quickly realized that it was more user-friendly than what we had been using before," he said. "The transition from the old system to TestDirectly was night and day as far as ease and simplicity, and fortunately for the DOC, Northwest can handle a very large volume, so 75 to 80 percent of our testing is going through Northwest."

Managing Thousands of Accounts Across the System

Sarah Sooter is an IT Admin and Quality Analyst at Northwest Laboratory. Since last summer, she has worked closely with Turner, helping him manage 26 staff members and 24 offender accounts that exist within the portal.

"The DOC does all of its testing on-site. They collect specimens from both employees and incarcerated individuals and then ship the specimens to us here at the lab," said Sooter. "We've processed about 200,000 tests since July of 2020, so they keep me busy."

Turner provided more details about the department-wide testing program, which has over 18,000 patient accounts.

When and Why Incarcerated Individuals Are Tested

"Our incarcerated individuals in the prisons are generally tested when it comes to pre-procedures like hospital visits, or when identified as part of contact tracing. Testing also takes place when they self-identify symptoms, or when DOC staff identifies them as being symptomatic," he said. "If there's an identified outbreak, we may do multiple rounds of testing, and those numbers can vary between 300 and 1,500 daily. It just depends on the size of the prison."

Testing of the incarcerated population is conducted in accordance with the department's COVID-19 Screening, Testing, and Infection Control Guidelines. 

Weekly Serial Testing for Staff and Work Release

Turner also oversees the serial weekly testing program for staff at correctional facilities and work release sites, which he estimates involves approximately 5,000 tests each week. The program also includes offenders participating in work release, who are tested weekly because they reside at work release facilities while regularly interacting with the broader community.

Lessons Learned After More Than a Year of Organizational Testing

Turner said the DOC's testing program works because TestDirectly (and TestDirectly.com) can handle large volumes, and it's an easy diagnostic lab software platform to train on.

A Scalable Direct-to-Consumer Lab Testing Portal Built for Large Institutions

"The platform is designed in a way that you can have very large institutions, all spread out, and each one of them has its own campaign or division within the portal,” he explained. "The portal features a single interface with role-based access that is managed through the administrator program, and that design makes training straightforward while ensuring users have the appropriate level of access. Depending on the site, between five and 20 staff members have been trained to use the portal, with permissions tailored to their specific job responsibilities." 

CSV Upload and Download Capabilities

Turner also highlighted TestDirectly's ability to import CSV files containing patient demographic information, allowing users to create patient profiles and set up batch testing events.

Moreover, the platform enables authorized staff to export test results as CSV files. Rather than opening individual reports, users can analyze all results in a spreadsheet, sort the data by outcome or other criteria, and quickly identify specific cases.

Ongoing Monitoring and Support

For Turner, his job these days is to maintain high-level relationships with the DOH and labs such as Northwest, while keeping the testing program on track and running smoothly. If any issues arise, Sooter is there to assist.

"All of the facilities have access to the TestDirectly provider portal, and they can monitor their TestDirectly results in real time. Beyond that, they also know to contact me via email if they have any questions related to the test results," said Sooter.

"We have a team of 12 to 15 occupational health and wellness nurses dedicated to monitoring test results and responding to positive cases across the state," added Turner. 

Bringing On Atlas Genomics as a Second Lab Partner

In the months since the pandemic began, there have only been a few virus outbreaks. There was a large one last fall that included the Airway Heights, Shelton, and Stafford Creek facilities - three of the state's largest. Due to the numbers involved, the Department of Health directed the Department of Corrections to add Atlas Genomics as another laboratory testing partner.

According to Turner, the transition to the new laboratory was smooth.

"Atlas had just integrated with TestDirectly when we started working with them, so we didn't have to change any patient profiles. It was seamless and as simple as creating a different campaign that generates a different order for a different lab," he said. "Since then, we've switched the routine staff testing to Atlas for those three sites. That's helped us spread out the testing among the labs we're using."

Streamlining the Workflow with Barcode Labels

Turner said partnering with Atlas proved even more beneficial when the laboratory presented a more streamlined workflow that replaced the need to print paper requisitions, a workflow that Northwest has since adopted.

"It was originally a requisition-based ordering workflow with the electronic order going to the lab once we submitted it in TestDirectly, and the printed requisitions were shipped with the specimens," said Turner. "Now there is a barcode label requisition, so instead of using the paper requisition, we have the option just to print a label."

Turner said the new workflow removes steps from the process for his testing teams.

"They just use one document and a barcoded label for the vial, as opposed to a label or sticker for the vial plus the paper requisition. It's a nice and simple feature," he said.

Faster Turnaround Times and Automated Reporting

Sooter agreed that the efficiencies created by TestDirectly and TestDirectly.com have positively impacted the speed at which specimens can be collected and shipped to the lab, as well as the time it takes for the lab to produce test results.

"Our goal for turnaround time is within 24 hours, and thanks to this partnership, we've consistently been able to meet and surpass that goal," said Sooter, who also referenced TestDirectly's automated delivery of consumer lab reports to DOC staff as a big time-saver.

"I love the fact that we can use the portal to notify patients via text or email when the results are ready. They can hop online and get their result right then and there," she said.

Strong Support from the TestDirectly Implementations Team

For Sooter, it was a baptism by fire about a year ago. Soon after Northwest hired her, she started serving as the main point of contact for Turner. She credits Adam Carlin and the TestDirectly Implementations Team for getting her trained on the platform and up to speed quickly.

"Working with Adam and his team has been great. They are always able to answer my questions in a timely fashion. I never have to wait around, and if it's something urgent, I can reach Adam directly," said Sooter.

For his part, Carlin said the feeling was mutual.

"We continue to streamline and improve processes while working with Sarah and the whole team at Northwest. If we need to troubleshoot on our end, Sarah is there to help within minutes,” he said. “She does the heavy lifting and sets up the calls with us to get any new clients up to speed. The system in place works well, and this has enabled Northwest Laboratory to continue to bring on more organizational testing business.” 

What's Next for the DOC and its Laboratory Partners

Turner and Sooter agreed that the partnership between the Department of Corrections and Northwest will remain in place for a while, and both are prepared for this.

"We're in collaboration with the Department of Health, and the vaccine percentages in society and cases by the county will probably dictate how long this continues," said Turner.

"The testing numbers have been very steady since July of 2020, and they've even increased slightly at times over the last few weeks, so yes, I feel like it's going to be in place for a while," added Sooter.

"It's sort of the new normal," continued Turner. "We're trying to establish how, as a department, we deal with COVID testing and outbreaks, while still returning to some level of a new normal at our facilities."

Until recently, family visitation for incarcerated individuals had been suspended as part of the new normal. However, Turner said plans are now in place to gradually resume visits, allowing families to reconnect with their loved ones. 

For Turner, this is one more challenge that he and his colleagues are preparing to take on as they steadily work to integrate roughly 18,000 patients into a normal day-to-day workflow.

"There's been a massive impact on what COVID has done. So, if there's not a degree of preparation and readiness at all times, then we're back to square one, and we're behind the curve trying to play catch-up again," he said.
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Direct-to-Consumer Lab Testing that's Convenient, Safe, Fast, and Accurate

TestDirectly is a flexible web-based direct-to-consumer lab testing and patient engagement portal that creates efficiencies for medical laboratories and care facilities while directly connecting with patients to provide convenient, safe, fast, and accurate direct-to-consumer testing. 

Discover More: Remembering COVID - Northwest Laboratory Leads the Way with its 24-Hour Commitment for COVID-19 Testing

The TestDirectly platform eliminates errors and reporting delays by replacing paper forms and manual processes with a user-friendly electronic clinical lab workflow that empowers patients and fully supports the case and the specimen throughout the testing journey.

TestDirectly is easy to deploy and integrates seamlessly with virtually any laboratory information system (LIS) and laboratory revenue cycle management (RCM) platform. The patient engagement portal streamlines the entire diagnostic lab workflow by supporting patient and family self-registration, appointment scheduling, capacity management, specimen collection, specimen tracking, laboratory processing, lab billing, and regulatory compliance.

The platform also automates result delivery through email, SMS, a secure patient portal, or system interfaces, while simplifying mandatory reporting to public health departments and agencies in all 50 states.

TestDirectly delivers a better, unified patient experience, providing direct-to-consumer labs with the tools they need to boost testing capacity, improve turnaround times, and support drive-through, walk-up, and all other forms of direct-to-consumer lab testing.

Discover More: Expand Laboratory Services to the Home and Improve Patient Engagement with New Direct-to-Consumer Lab Testing Business Models

Ready to Streamline Your Organization's Direct-to-Consumer Lab Testing Program?

If your organization needs a scalable, easy-to-implement direct-to-consumer lab testing solution like the Washington State Department of Corrections found with TestDirectly, we're here to help. Whether you're managing testing across multiple sites, coordinating with laboratory partners, or hoping to replace paper-based workflows, TestDirectly can be configured to fit your needs.

Let’s Chat: Contact a TestDirectly specialist today!

Frequently Asked Questions About Washington State DOC's COVID-19 Testing Program

How many facilities does the Washington State Department of Corrections manage COVID-19 testing for?

The Washington State DOC oversees COVID-19 management and testing across all 24 facilities in its system, coordinating with headquarters to keep the program running smoothly statewide.

What platform does the Washington State DOC use for COVID-19 testing?

The DOC uses the TestDirectly Direct-to-Consumer Lab Testing and Patient Engagement Portal, which it adopted through a partnership with Northwest Laboratory (now Avero Diagnostics) starting in mid-2020.

How many COVID-19 tests has the program processed?

Northwest Laboratory alone processed approximately 200,000 tests for the DOC since July of 2020, as part of a department-wide program covering over 18,000 patient accounts.

How often are DOC staff and incarcerated individuals tested?

Staff at correctional facilities and work release sites participate in a serial weekly testing program that totals approximately 5,000 tests each week. Incarcerated individuals are tested as needed for pre-procedure screening, contact tracing, symptom evaluation, and outbreak response, with daily testing volumes ranging from 300 to 1,500, depending on the facility. 

Why did the DOC add a second laboratory partner?

Following a significant outbreak at the Airway Heights, Shelton, and Stafford Creek facilities, the Washington Department of Health directed the DOC to bring on Atlas Genomics as an additional laboratory partner to help manage increased testing volume.

What turnaround time has the testing program achieved?

Northwest Laboratory's goal is a 24-hour turnaround time for results, a benchmark the lab has consistently met or exceeded thanks to the efficiencies created by the TestDirectly platform.

How do patients receive their test results?

TestDirectly supports automated report delivery, notifying patients via text or email as soon as results are ready so they can access them directly through the online portal.