By Allison Proffitt
April 21, 2021 | The COVID-19 pandemic required monumental business shifts across industries, and the diagnostics industry is no different. At the beginning of 2020, Aegis Sciences was a Nashville-based national toxicology lab, and their closest relationships were with pain management doctors for whom they conducted opioid and other substance testing. In addition to the toxicology lab, they had a small biopharma lab with less than 10 employees.
But Frank Basile, the CEO of Aegis, is a medical doctor and he couldn’t pass up the opportunity to contribute to patient care by taking on COVID-19 testing.
“We decided, let’s see if we could do COVID testing. We started out as more of a proof-of-concept to do 3,500 samples a day on the COVID side,” explained Tim Ryan, Chief Information Officer at Aegis. “We launched that quickly in April .”
From there, Aegis quickly expanded the goal: 5,000 tests per day, 10,000 tests per day, more. By September 2, 2020, Aegis had been awarded a National Institutes of Health Rapid Acceleration of Diagnostics (RADx) grant for $6.6 million to expand COVID-19 testing capacity to 60,000 tests per day by September 30. The company now has the capacity to do 110,000 COVID-19 tests per day and is committed to a 48-hour turnaround time—including time needed to transport samples from testing sites nationally to the Nashville lab space. They are planning to expand to 130,000 tests per day.
Ramping Up, Scaling Out
While the Aegis’s toxicology business carried on—slowed by the shutdown and decreased doctor’s visits, of course—COVID-19 testing was exploding as a new, parallel business. In the past year, Ryan said, the company has hired about 500 staff, developed and filled a 22,000 square foot lab space, much of which was previously office space, and set up a call center and logistics team.
Ramping up test capacity meant increasing lab space, equipment, consumables. “It became a facilities project; we had to convert office space into lab space without knowing really what the endgame is, and without having significant working capital to do everything,” Ryan explains.
But the growth has also required significant IT system investments and updates—not the least of which was a storage system capable of scaling to the company’s new test volume.
Several years ago, Aegis chose Pure Storage as their data storage platform, Ryan explained. Part of the value proposition then was Evergreen, a Pure Storage subscription model that advertised easy upgrades to storage as needed. And Aegis tried and tested proposition.
“We were able to get infrastructure upgraded within 30 days, and that includes getting additional infrastructure sent to us from Pure,” Ryan explained.
“From the IT side, because of the solid architecture we had, we have had near-perfection from an IT side. Nothing’s perfect, but just being able to handle the additional volume with only minor issues. A lot of that is due to our architecture with Pure. I really can’t say enough about what Pure has given us the capability to do.”
On the software side, Aegis needed a patient portal to return test results quickly and securely. “We built a brand-new patient portal—which is secure and also verifies your information—within weeks. So we could have patients get their information online instead of waiting for their physician or wherever they got their test from—an urgent care—to contact them.”
As a national lab, Aegis needed to be able to return results to public health departments all over the country. “We did not have that connectivity previously—and each state is different. Unfortunately, from an IT perspective, it’s a federated model; every state makes their own decision. There wasn’t one standard way of interfacing with the states.” And there is quite a range of preferred methods: some states use HL7 to receive results online, others require CSV files, still other public health departments, Ryan said, are still using fax.
Next Stop: NGS
The company is still adjusting and expanding its business. In early February, Aegis and Walgreens announced an expansion of their COVID-19 testing agreement to substantially increase their testing capacity. Meanwhile, Aegis has also announced a new toxicology test for their original business. BioDetect, a service launched last month, is a method to detect synthetic urine giving care providers greater insight into patient’s medication adherence.
And last month, Aegis announced an agreement with the Centers for Disease Control and Prevention (CDC) to deliver SARS-CoV-2 sequencing analysis to enable strain identification and further the detection of novel mutations in the virus. Aegis will perform next-generation sequencing analysis of positive samples, and the viral genomic sequences will be provided to the CDC, along with geographic source information.
It’s another IT challenge. “We had to create interfaces to the CDC. We did have to go out and purchase an Illumina platform for next-gen sequencing. We had to get that equipment and stand that up very quickly,” Ryan said. “That’s a new capability for us.”
It’s been a year of explosive growth, but Aegis has risen to the challenges. “What we want to do, is we want to service the patients. We want to provide the best level of service to the patients with our quality testing,” Ryan said. “I can’t say enough about the teamwork that the company has exhibited.”