Case Study
Sponsored by an educational grant from QuidelOrtho
The solution: test-and-treat outside of primary care
Duane Jones, BS Pharm, PD
New technologies are providing user-friendly options which facilitate testing outside of the
laboratory or clinic. Many patients have limited access to care due to provider shortages,
transportation issues, lack of health insurance, or expense. If they can’t find primary care, they
may wind up in the emergency department—which burdens our already strained healthcare system.
Conversely, patients can walk into their local pharmacy and test for COVID-19, strep or flu and
receive treatment. According to a 2022 study published in the Journal of American Pharmacists
Association, approximately 89% of Americans live within five miles of a community pharmacy.3
This situates pharmacies as local resources to help eliminate health disparities and accelerate
public health initiatives.
Not everyone agrees. The American Medical Association released a statement in June of last year
coming out against expanding test-and-treat policies beyond medical doctors.
“While pharmacists and physicians each play important roles in healthcare delivery, the
length, breadth, and focus of their education and training are vastly different and prepare
them for separate and distinct roles in patient care. Pharmacists are medication experts,
but their clinical training does not prepare them to perform physical or mental examinations,
diagnose patients, interpret test results, or provide primary care services; the independent
practice of medicine by pharmacists puts patient health and safety at risk.” 4
Rather than getting involved in polarizing conversations, Duane prefers to focus on how pharmacists
can collaborate with healthcare professionals nationwide. “We have to get beyond thinking about
self-preservation and have to think about putting the patient back at the center of care.” While not
all states permit pharmacists to test and treat patients, in states where that is permitted, Duane
recommends that these programs be protocol driven and used in conjunction with a referral system
for local physicians. At Harps, a dichotomous decision tree is used: If they test negative, they don’t
treat. If they test positive, the patient receives the proper care that they need. “We practice at the top
of our license on behalf of the patient,” insists Duane. “We actually become a great referral source for
physicians because if the patient tests negative, but they still have some severe symptoms, we’ll
refer them on to their physician for care.”
Because the test-and-treat protocols are evidence-based, they have documented both improved
outcomes and antibiotic stewardship. Duane elaborates that when seen at a physician’s office...
“Statistics show that about 52% of the patients that are treated for flu actually weren’t tested.
They were empirically treated with antiviral medication. In fact, data indicate that only 25% of those
patients tested positive.5 So we’re overprescribing antibiotics and antimicrobials. And what that leads
to is resistant strains that can potentially become life-threatening.”
A little help from our friends
There are several barriers that exist for pharmacists to be able to implement test-and-treat programs
to improve patient care, namely test availability, time and reimbursement. Harps systematically
addressed all three during the creation of their pilot program. First, the task was to select the right
assay for their pharmacies. There are lots of point-of-care platforms to use for test-and-treat.
Duane chose QuidelOrtho assays. He explained why: “We started our test-and-treat program back
years ago when state laws were silent on whether or not pharmacists could do point-of-care testing.
We wanted to make sure that we had the best system and did some research to find out what the
clinics were using. We went with Quidel.” QuidelOrtho is one of the largest manufacturers of clinical
testing equipment in the United States and their specialists trained Duane’s pharmacy staff, using
the same protocols with the same hardware as found in point-of-care assays in primary care,
urgent care or a hospital settings. They also created marketing materials to promote test-and-treat
at pharmacy sites.
Next, Harps pharmacists had to tackle time constraints. Pharmacists are always busy, and many
don’t have the time to provide enhanced clinical services to patients. The Harps solution was to
institute a workflow that put pharmacy technicians in charge of all non-clinical operations, including
We have to get beyond
thinking about self-
preservation and have
to think about putting
the patient back
at the center of care.”
3. Berenbrok LA, Tang S, Gabriel N, et al. Access to
community pharmacies: A nationwide geographic
information systems cross-sectional analysis.
J Am Pharm Assoc. 2022;62(6):1816-1822.e2.
4. Leadership. American Medical Association.
Published June 18, 2025. Accessed May 27, 2025.
https://www.amaassn.org/about/leadership.
5. Klepser DG, Corn CE, Schmidt M, Dering-Anderson
AM, Klepser ME. Health Care Resource Utilization
and Costs for Influenza-like Illness Among
Midwestern Health Plan Members.
J Manag Care Spec Pharm. 2015;21(7):568-73.
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