Amedisys measures success by the quality of care we provide and the satisfaction of our patients and families. As part of reaching the goal of providing high-quality care, we continually seek out opportunities to offer leading-edge healthcare services to our patients.
To that end, in 2022 the opportunity to leverage advanced molecular testing technology to rapidly identify infections was presented to Amedisys. Patients Choice Laboratories, a leading provider of comprehensive laboratory testing throughout the United States, uses the innovative approach to look for specific biomarkers in laboratory samples, enabling more accurate identification of infectious pathogens. Amedisys understood the value of advanced molecular testing in improving patient outcomes and was eager to incorporate this approach to treating patients.
“Amedisys is the first home health company that has implemented our molecular testing nationwide in all of their care centers,” notes Dan Johnson, Senior Executive Sales Representative for Patients Choice Laboratories.
What is Advanced Molecular Testing?
Advanced molecular testing, also known as molecular diagnostics, refers to a group of tests that examine the genetic material in a specimen. These tests can detect genetic risk factors for certain diseases or provide evidence of infections in the body, by looking for segments of DNA (deoxyribonucleic acid) or RNA (ribonucleic acid) known to have associations with specific health conditions.
[action 1]
It is currently estimated that at least 700,000 people worldwide die each year as a result of antimicrobial resistance (AMR), with the World Health Organization predicting that number could increase to 10 million by 2050. This makes it crucial that healthcare organizations adopt innovative strategies to identify infections and choose the appropriate antimicrobial treatment.
By utilizing advanced molecular testing, clinicians can revolutionize the diagnosis and management of infections. This approach delivers rapid and precise results, ultimately enabling faster initiation of appropriate treatment interventions. At Amedisys, this testing is utilized to identify urinary, wound and respiratory pathogens with greater accuracy than standard testing.
Molecular testing for urinary tract infections
“A culture test is going to identify one or two bacteria,” explains Johnson. “Typically, with the molecular tests, we might see up to eight bacteria identified in a single test, with all eight of those bacteria known as a cause for UTIs.”
Molecular testing for urinary tract infections:
- Returns results within 12-24 hours
- Analyzes bacterial DNA to determine antimicrobial resistance
- Is unaffected by concurrent antibiotic use
- Provides specific antimicrobial treatment recommendations based on findings
- Can be performed using either a clean catch sample or as little as a urine swab from an adult brief or pad
Molecular testing for respiratory infections
Identifying respiratory infections early reduces the risk of severe illness and hospitalization and the spread of disease. Molecular testing utilized by Amedisys for respiratory infections includes:
- COVID/Flu/RSVP Panel
- A viral panel which covers:
- Adenovirus, bocavirus, enterovirus, HHV3 (varicella zoster virus), HHV4 (Epstein-Barr), cytomegalovirus, rhinovirus, Bordetella pertussis, and other common viral respiratory infections
- A bacterial panel looking for several sources of bacterial pneumonia
- A strep panel
Like the molecular urinary testing, results are available in just 24 hours, analyze viral and bacterial DNA to determine antimicrobial resistance, are unaffected by concurrent antimicrobial use, and include specific treatment recommendations based on findings.
Molecular testing for wounds
For patients who exhibit overt clinical signs and symptoms of an infection or have a wound that is either deteriorating or stagnating and not progressing towards healing, Amedisys’ wound protocol includes molecular testing for wounds. This testing, performed via swab:
- Improves sensitivity with PCR testing
- Returns results in 12-24 hours
- Analyze bacterial DNA to determine anti-microbial resistance
- Is unaffected by concurrent antibiotic use
- Provides specific antimicrobial treatment recommendations based on findings
The Benefits of Advanced Molecular Testing
As noted above, employing molecular testing in the home health setting allows providers to detect specific pathogens more quickly. This in turn helps avoid unnecessary hospitalizations. With traditional laboratory tests, it may be possible to identify the presence of an infection, but further culture results identifying the specific target pathogen for treatment can take days.
Often, by this time a patient’s condition has worsened because the optimal treatment was not yet known. Amedisys aims to help its patients avoid unnecessary hospitalizations and recover more quickly from acute and chronic infections.
There are several key benefits to molecular testing vs. traditional laboratory tests:
- Improved sensitivity due to polymerase chain reaction (PCR) testing
- Results within 24 hours (rather than five days for a culture)
- Identification of antimicrobial resistance using analysis of bacterial and viral DNA
- Comprehensive anti-microbial treatment recommendations included in the results
- Results are not affected by concurrent antimicrobial use
- Samples are easy to collect in the home
This means that molecular testing beats standard laboratory cultures not only in speed of results, but also accuracy — in the case of urinary cultures, for example: “A culture test is about 60% accuracy on a good day when it's doing well. Molecular testing is at 97% accuracy,” notes Johnson.
The Real-World Impact of Molecular Testing
Amanda Foshee, MD, a family medicine doctor in Section, Alabama, has been especially impressed by what she’s seen since she started partnering with Amedisys to use molecular testing to identify urinary tract infections in the patients enrolled in Amedisys Home Health. “It’s made a huge difference in turnaround time,” she shares. “I get results the next day with this, and I’ve never had an issue with it failing to identify an organism when there was one present.”
Additionally, she notes that she is confident that molecular testing helps accurately pinpoint the correct antimicrobial treatment. “I’ve not had many patients treated based on these recommendations that have had the same infection again,” she states.
Foshee’s experience with molecular testing through Amedisys prompted her to seek the option for her own private practice. To her, it was an easy decision: “I can begin patients on an appropriate antibiotic that much sooner, rather than waiting two to three days for a traditional lab, which might not return as accurate a result.”
What is the Future of Molecular Testing?
As noted in a recent article in the Journal of Clinical Microbiology, continued advances in molecular technology will likely make common testing approaches like cultures irrelevant when it comes to routinely diagnosing patients. Another analysis calls it “a revolution with no signs of slowing.”
Because these advances positively impact patient outcomes, “This will be the new standard of testing very quickly,” states Dan Johnson. Taking this approach defines organizations who are forward-thinking and dedicated to excellent patient outcomes — like Amedisys.
By choosing advanced molecular testing, we can help prevent unnecessary illness and even death due to infection in our patient populations, making us the home health organization of choice for patients and providers alike.
