A Queuing Simulation Model of Point-of-Care Diagnostics Testing in a Retail Pharmacy
Open AccessIn 2015, the United States Food and Drug Administration (FDA) approved the first Clinical Laboratory Improvement Amendments (CLIA) waived molecular diagnostics point-of-care test for influenza, launching the shift from centralized diagnostic labs toward immediate near-patient testing. The ability to test patients and provide accurate results in under 30 minutes has proven to be invaluable in emergency rooms and urgent care centers. However, as demonstrated by the COVID-19 pandemic, the ability to quickly test residents of communities makes a significant difference in controlling outbreaks. The future of point-of-care testing will be widespread adoption in retail pharmacies such as Walgreens and CVS.This research uses queuing simulation modeling to deliver a decision support tool that identifies effective implementation strategies for point-of-care testing in retail pharmacies. Effective implementation is defined by the lowest operational costs, shortest patient queue times, and the lowest impact on pharmacy service times. The simulation model assists the pharmacy manager in making decisions to integrate point-of-care testing into the existing prescription drug dispensing and immunization workflows. This research tested five molecular point-of-care diagnostic devices with differing hands-on time integrated into the pharmacy drive-thru. In addition, different testing volumes were simulated and the impacts on queue and service times were assessed. Finally, drive-thru and in-store testing workflows were simulated and compared. The results show that devices with the lowest hands-on time have the lowest cost to operate and least impact to pharmacy service times. Devices with lower hands-on time can also perform a higher volume of tests before affecting pharmacy service times as compared to devices with higher hands-on time requirements. Lastly, performing patient sample collection and testing inside the store instead of at the drive-thru will reduce the impact to drive-thru queue times and pharmacy service times.
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