The SalivaDirect newsletter featured our Santiam Hospital SCoPE lab in their November 2022 edition. The article reads: Kicking off November, Rylie Tiffin from Santiam Hospital SCoPE Lab joined the SalivaDirect Monthly Lab Call to share highlights of how her team continues expanding COVID-19 testing... access for vulnerable populations in rural Oregon. Here’s an overview of the presentation she shared.
“SalivaDirect allowed us to accomplish so much for this community and our state as a whole,” says Rylie Tiffin, Regional Testing Coordinator for Oregon Health Authority’s Region Two. “Our ability to run the SalivaDirect FDA EUA test meant we never had to say “no” or turn away a single patient in need of COVID-19 testing. Saliva-based testing made all the difference in this program.”
In 2021, the Santiam Hospital SCoPE Lab joined state health officials to develop public health infrastructure and provide COVID-19 testing services in their rural region of the Pacific Northwest. The program targeted the area’s uninsured population, those in congregate care settings, migrant and seasonal farmworkers, food processing plant employees, and communities disproportionately affected by COVID-19, such as people of color and those with disabilities. “Region Two spans nearly 7,000 square miles across six counties located between two mountain ranges in northern Oregon. Aside from the geography, our biggest challenges involved overcoming mistrust in the American healthcare system,” said Tiffin.
From the start, Santiam began integrating its COVID-19 testing services with more than 100 well-established community organizations. Leveraging existing networks aided rapid information flow and coordination, so important during the Delta and Omicron surges. “For us, providing equity-based testing started with our local partners. They vouched for us. They also helped us quickly identify and overcome barriers. Their assistance helped our program evolve a no-wrong door service approach, which further eased community skepticism about testing and healthcare in general,” said Tiffin.
Saliva-based PCR testing with SalivaDirect also served an important role. Tiffin highlighted that the ability to self-collect saliva enabled them to nearly double the number of patients tested in a single night and squelch the spread of Omicron during a local surge. Also, the extraction-free SalivaDirect PCR method contributed to providing test results to patients much more quickly than other methods in use. “Health officials recognized how we were able to identify positive cases much earlier for a whole county, even though our lab was located over an hour away from them,” said Tiffin.
The stability of saliva samples compared to nasal swabs also made a difference in rural Oregon. “Since we don’t need to refrigerate test kits or saliva samples, mailing them to and from various remote areas throughout the state helped us reach isolated groups of people,” says Tiffin. Now, numerous local public health authorities and community organizations can store SalivaDirect at-home test kits for rapid use to address outbreaks. “After collection, they courier or ship patient samples to us, and our lab provides next day results. The time and resources saved compared to using nasal swabs has been a game-changer.”
“All of us at Santiam Hospital and Corban University are particularly proud of our ability to provide vital pandemic services to this part of our community,” said Sarah Comstock, PhD,MB(ASCP), Founder of Santiam Corban PCR Enterprise Lab and Biology Professor at Corban University. “SalivaDirect helps lower so many barriers. The test itself is streamlined, easy to use, and returns same-day results. With our regularly stocked reagents and existing equipment already in the EUA, it’s one of the most cost-effective tests we run. As a nonprofit, we pass those savings on to patients, testing providers, and the public health system.”
For this testing program alone, Santiam provided SalivaDirect COVID-19 tests for 9,043 patients in six counties. They hosted 96 testing events, and community partners facilitated remote testing by shipping thousands of self-collected specimens to the Santiam Hospital SCoPE lab. Of the individuals served, 84 had a disability, 21% were uninsured, and 13% spoke one of 14 languages other than English. More than 120 Native Americans from at least 14 tribes participated in COVID-19 testing.
The Oregon Health Authority recently renewed the original grant to Santiam Hospital. During 2023, the team will continue strengthening and expanding the newly created Region 2 testing framework to ensure sustainable access for vulnerable populations now and beyond the COVID-19 public health emergency.
Rylie encourages labs to view their diagnostic capabilities through a public health lens. “The pandemic pushed us to expand traditional lab functions into the field,” she said. “One by one, our partnerships built trust and opened doors into the community. I’m confident this groundwork will continue to facilitate ongoing care coordination and service integration for those who need it most.” Tiffin adds, “In the fight for equitable healthcare, saliva-based sample types may be the first step.”
Santiam Hospital & Clinics Scope Lab