Sacramento doctor puts JAX employees to the test

COVID-19 testing, CLIA Lab, The Jackson Laboratory
Dr. Tepper collects samples from JAX employees in Sacramento as part of JAX's COVID-19 testing program for employees. JAX photo by Victor Cuevas.

When The Jackson Laboratory's leadership team made the decision to implement a phased return to onsite work for remote employees, COVID-19 testing was at the heart of their plan.

JAX President and CEO Ed Liu underscored the importance of testing in a video address to employees in Spring 2020.

“Starting in May and continuing into the summer, we will embark on transitioning to full onsite work. The goal is: return to full productivity in a pandemic safe manner to a new normal that is vigilant and responsive. We will do so in a structured and organized manner – in phases – and learn from each phase. The absolute core to a successful transition to a functional economy is universal viral testing. We must ascertain that the workplace will be infection-free, and that onsite, as well as returning employees, are not carrying the virus.”

Confident that its CLIA lab at The Jackson Laboratory for Genomic Medicine (JAX-GM) in Connecticut could test the samples gathered from employees, JAX sought out healthcare partners to administer the tests. Local hospitals joined forces with JAX in to conduct the tests for employees in Maine and Connecticut.

But in California, a hospital partnership was elusive. Local hospitals were reluctant to commit to the ambitious timeframe and onsite testing that JAX needed for its employees. The senior leadership team came together to develop a testing solution for the Sacramento site. Madeleine Braun, chief for presidential initiatives; LuAnn Ballesteros, vice president for external and government affairs; Charles Lee, scientific director at JAX-GM; Kathy Vandegrift, associate general manager and site director for JMCRS; and John Ryan, general counsel; collaborated to identify testing partners and streamline logistics.

Going the distance for COVID-19 testing

Tepper had transformed his office into a concierge medicine practice in 2016. Concierge medicine charges a membership fee to patients. In exchange for that fee, patients receive more direct care from the physician, extended office hours and house calls, and a strong focus on wellness and preventive medicine.

One of the tenets of concierge medicine is to meet the patient where they are. In the case of JAX, this was literal. From a tent in the parking lot of JAX’s Sacramento facility, Tepper met with 366 employees to collect their specimen samples to be sent to the CLIA lab in Connecticut for testing.

“Part of the whole philosophy of concierge medicine is to meet the need, whatever that need may be,” says Tepper. “I’m able to customize care to the situation. JAX needed to get a whole lot of tests done as efficiently and quickly as possible, and it didn’t want people to miss work. Employees want the test to be as comfortable as possible and get it done as quickly possible.”

Supported by a team of three medical assistants who register each patient as they arrive and manage the computer records related to each test, Tepper quickly fell into a rhythm of meeting employees and collecting samples for testing. He appreciated the brief moment when each employee would remove their mask to be swabbed.

“You get used to seeing everyone in a face mask,” he says. “But suddenly seeing everyone’s nose, their face – I liked being able to see the people I was testing.” Other things that stand out about conducting testing at JAX: “I met the tallest person I’d ever met. The gentleman was 7’ 2” – and testing is done standing up – so I had to really reach.”

Another distinct memory: the gloves. So many pairs of gloves. Taking off and putting on new pairs of gloves every one to three minutes hundreds of times each day may just be a personal record for the physician. Speed and endurance are familiar concepts to Tepper. He’s a runner who gravitates toward longer distances, having completed several marathons. He admits that his miles have decreased during the pandemic.

“There are no races. They’re all canceled. Those races keep me motivated to run. I had planned to do the Avenue of the Giants, a marathon through thousand-year-old giant redwoods over gently rolling hills, and a 50K ultramarathon, the Skyline to Sea race near Santa Cruz.”

The right doctor for the job

Kathy Vandegrift, associate general manager and site director for JMCRS, is also a runner. She sees the qualities that makes Tepper a distance runner also makes him an ideal medical partner for employee testing.

“He has a willingness to patiently work through new concepts,” Vandergrift says. “He was adaptable as we worked through the best testing method and developed a tent operation and software solutions. He saw the value of the end goal and was okay that there would be bumps as we implemented a solution.”

That value of the end goal and flexibility in pursuing solutions are what motivated Tepper to convert his medical practice to the concierge model. The deciding moment may have come as he worked with a patient in her 80s who had recently had a hip replacement. She was at home and called to let him know that she had a fever and didn’t feel well. She was unable to travel to Tepper’s office, so he used his lunch break to do a home visit and ensure that she received the care she needed.

After weeks of unsuccessfully trying to arrange payment from the insurance company, Tepper knew it was time for a change.

“I needed to find a way to let me do the right thing in medicine for my patients,” he says.

Vandegrift can see the patient-first approach throughout Sacramento's employee testing.

“Dr. Tepper demonstrates both care for people and patience with processes,” she says. “His staff also upholds these same characteristics, which made for a wonderful experience overall for the JAX employees during testing.”

It turns out this collaboration with JAX has benefitted Tepper and his patients as well. When his patients need a COVID-19 test, he now sends their samples to the JAX CLIA laboratory for testing which consistently provides results within 24 – 48 hours.

“Early on, it took local California labs two days to turn around test results. With the recent surge in California, it’s taking seven to 10 business days. So I now pack up the samples and ship them to the JAX CLIA lab. It’s quicker to get results.”

It’s yet another example of Tepper’s ability to meet a given situation, and it underscores the value of one of JAX’s contribution to the battle in the COVID-19 pandemic.

How does testing work?

There is so much confusion around COVID-19. What are the symptoms? How do you know if you should get tested? What is the test like? And what happens behind the scenes? This short video will give highlights of the process.