1. Direct Access Testing Nicole Lemieux MLS (ASCP) cm Jamestown Regional Medical Center

2. Overview JRMC Direct Access Testing (DAT) How to implement DAT Challenges

3. JRMC Jamestown Regional Medical Center Located on I-94 in Jamestown, ND New facility in 2011 Critical Access Provide care to 55,000

4. Jamestown, ND Population 15,000 Three clinics – Sanford Health (two locations) – Essentia Health University of Jamestown VA Clinic Central Valley Health Unit North Dakota State Hospital/James River Correctional Center

5. Direct Access Testing DAT- consumer initiated testing “Direct – to – consumer” “Patient - authorized”

6. Benefits Lower out of pocket costs Allows for more frequent testing than insurance plans cover Quick turn around No appointment or doctor’s order Convenience Allows for more involvement in own health care But… not a substitution for an appointment with a provider

7. The Idea Started in 2011 Lots of research – Other facilities that do DAT – Internet – Direct Access Laboratories

8. Getting Started Talk to your Medical Director Talk to your local providers Talk to your Administration

9. Early Obstacles Getting providers onboard Picking tests Setting prices

10. Implementing Marketing – Brochures – Radio – JRMC-U – Newspaper Ads Articles – Women’s Groups – Waiting Rooms, Hair Salons, Clinics, anywhere

11. Implementing Logistics: – Patient presents to Admission Must be at least 18 – Patient comes to Lab – Lab delivers results with Exit Care instructions – Hours: Daily 7 am – 9 pm

12. Implementing Billing – Payment required before services Cash, credit card, check – Insurance not billed – May submit to flex programs or insurance companies BC/BS coming on board soon

13. Tests Offered Influenza ($40) Lipid Panel ($30) TSH ($30) Clean Catch Urinalysis ($25) Hemoglobin A1C ($20) Rapid Strep ($20) ABO/Rh ($15) Pregnancy Test – Blood/Urine ($15)

14. Cost Calculation Tech time + cost of test + $5-10 Less than insurance prices

15. Challenges After Implementing Getting the word out Explaining results What to do with results Physicians Hospital Employees

16. Patient Demographics All ages – Mostly children Young families and college students Most popular tests: 1.Rapid Strep 2.Pregnancy 3.Clean Catch Urinalysis

17. Today Physical Therapy Direct Access Other Ancillary Departments – Radiology

18. What Comes Next? Continued advertising – Radio – Community Events – Women’s Groups New Tests – UC, INR, chemistry, prenatal Tele Doc Constantly evolving

19. Questions? Brochures, Exit Care, Order Forms, Contact Info

20. Thank you! Contact: – Mary Bowder, manager JRMC Laboratory mbowder@jrmcnd.com 701-952-4779 – Nicole Lemieux nlemieux@jrmcnd.com