5 Types of Specialty Care Supported By Home Diagnostics

Home diagnostics like dried blood spot tests, urine tests, and self-swabs can support remote specialty care, from colorectal cancer screening to at-home STI tests, at-home PrEP medication maintenance, women+ care, and remote dermatology telemedicine. Ash Wellness partners with digital health companies and healthcare providers to enable 150+ home diagnostics in all 50 states. We offer a seamless API platform, white-labeled test kits, a network of CLIA/CAP labs, physician of record network, and accessible billing options. In this blog, we outline how home diagnostics can support five types of specialty care.  

1. At-home Colorectal Cancer Screening

The CDC recommends regular screening for colorectal cancer starting at age 45. Colorectal cancer screening tests can find precancerous polyps (abnormal growths) before they turn into cancer, as well as early colorectal cancer. Persons with preexisting conditions like Crohn’s disease or ulcerative colitis or a family history of colorectal cancer may need to participate in a colorectal cancer screening earlier than 45. 

Population screening initiatives like the one conducted at Penn Medicine can improve patient outcomes on a massive scale, especially for marginalized communities. Researchers at Penn Medicine were able to increase colorectal cancer screening rates tenfold at a community health center serving primarily people of color.

Penn Medicine researchers sent a fecal immunochemical test to patient homes (unless they opted out via a text message prompt). After initial kit delivery, three follow-up texts nudged patients to mail fecal immunochemical test samples to the lab, where medical personnel reviewed results. At-home colorectal cancer screening as an intervention — measured by kit return rates — increased by 17 percentage points in an at-risk patient population, half of whom were Medicaid beneficiaries.

2. At-home STI Test Initiatives 

With STI rates on the rise in the United States and around the world, healthcare organizations like the CDC and WHO urge flexible new models of STI services. STIs like syphilis not only impact sexually active adults, but also pregnant mothers who can pass syphilis onto a fetus. Untreated STIs may cause infertility, organ failure, cancer, and sometimes death, but at-home STI test initiatives can help patient populations access testing and treatment services. 

As a result of reductions in access to STI testing during the COVID-19 pandemic, some government institutions have already explored at-home STI test kit initiatives to limit spread and access at-risk communities. California bill SB 306 mandates state-regulated healthcare plans expand provisions to include home STI kits covered by insurance. 

The Fulton County Board of Health partnered with Ash Wellness to provide free at-home STI test kits to residents in the Atlanta area, including dried blood spot cards to perform 4th generation HIV tests and triple-site testing for chlamydia and gonorrhea. 

How Fulton County residents access at-home STI test kits:

1. Order an at-home STI test online
2. Receive the self-test kit in the mail
3. Collect samples and mail them to the lab
4. Review results within 3-5 days in the while-labeled Fulton County portal 

Fulton County follows up with residents who test positive. 

3. Women+ Care

Gender bias still negatively impacts women in healthcare, and one in five women say they have felt that a healthcare provider has ignored or dismissed symptoms. Cardiovascular disease is underdiagnosed in women, two thirds of Americans living with Alzheimer’s are women, and women have greater morbidity than men. Race also plays a factor: Black women have a 40% higher breast cancer death rate than white women. 

Digital health companies like Noula and Caraway Health have built care models to support women+ patient populations through telehealth services, which can include mental health support, reproductive care, and physical health services. Home diagnostics help digital health companies support women+ patient populations with features like remote hormone panels, at-home STI tests, and wellness screenings. Ash Wellness partner Go Doc Go provides HPV at-home diagnostic test kits to communities in Alabama. 

4. At-home PrEP Medication Adherence

At-home PrEP testing for creatinine levels every six months and HIV every quarter may improve long-term medication adherence. When taken as prescribed, PrEP reduces the risk of getting HIV from sex by about 99%. In 2020, about 25% of people for whom PrEP is recommended were prescribed it, compared to 3% in 2015. However, according to a JIAS study, only two out of every five users persisted on PrEP over a two year period. 

One barrier to care for PrEP users is in-person testing. Public health departments, community based organizations, and digital health companies that offer at-home PrEP through remote diagnostics check HIV status and kidney function with mail-in dried blood spot tests. DBS cards are a useful intervention to maintain PrEP patients over the long-term, especially those who might not otherwise regularly interact with healthcare. 

With the rise of telehealth post-pandemic, remote medication maintenance services like at-home PrEP are likely to increase. (In a recent poll from Elevance Health, the majority of virtual care users (16%) choose telehealth to manage prescriptions.) 

For organizations that rely on government funding, such as Ryan White, at-home PrEP also supports grant compliance. Health Resources and Services Administration' s HIV/AIDS Bureau (HAB) “encourages Ryan White HIV/AIDS Program (RWHAP) recipients and providers to leverage the RWHAP infrastructure to support PrEP services within the parameters of the RWHAP legislation.”

5. Dermatology Telemedicine 

As with many types of telehealth, dermatology telemedicine boomed during the COVID-19 pandemic. Digital health companies like DirectDerm and Apostrophe launched remote care services in the United States for teledermatology. Remote care can connect patients to a board-certified telemedicine dermatologist, sometimes faster than in-person care. 

Telehealth services may not completely replace in-person dermatology, but the American Academy of Dermatology supports teledermatology, and recommends remote care for:

• Maintenance treatment for chronic health conditions 
• Support for visible skin, hair, and nail conditions
• Supplementary care for those who live in remote areas

While patients need to visit an in-person clinic for skin biopsy, dermatologists conduct lab tests, including blood tests and urine analysis to diagnose systemic disease associated with skin lesions. Dermatologists who prescribe Isotretinoin as acne therapy can also use home diagnostics to perform routine cholesterol, triglyceride and LDL-cholesterol tests. 

Ash Wellness offers 150+ diagnostic tests to support all types of care, including medication adherence, population health, primary care, and digital health. Schedule a time to chat about how to reach and maintain patients and customers with our unique platform. 

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