Introduction COVID-19 placed additional strain on an already struggling healthcare system. In response, tele-health and other novel solutions have been tried, including vehicle-based screening platforms. However, these modalities have limitations in the evaluation of ill patients, and there is significant room for innovation in healthcare delivery. The aim of our study was to evaluate the effectiveness and efficiency of a drive through medical treatment system in the setting of the COVID-19 pandemic. Method We designed a prototype drive-through medical treatment (DMF) to allow full evaluation, dispositioning and treatment of patients with potential COVID-19 symptoms to our Emergency Department. It was designed with several factors in mind: handling a large volume of patients quickly and efficiently; effectively triaging patients based on risk; fully evaluating, treating, and discharging low risk patients who may be infected with COVID-19. A retrospective chart review was performed to extract clinical and logistical metrics. Results A total of 2164 patients were evaluated between 1 May and 1 July 2020. Overall accuracy for patient classification was 92.6% (95% CI 91.4-93.6%). Screening criteria resulted in a return with need for extensive workup and/or admission rate of 0.25%, yielding a sensitivity of 86% (95% CI 68-96%). Of those presenting to the DMF, 179 patients (8.3%) were diverted to the main ED for further evaluation, of which 14% received diagnostic workups and 9% required admission to an inpatient service, yielding a specificity of 92.8% (95% CI 91.7- 93.9%). Patients seen in the DMF had shorter length of stays than those seen in the main Emergency Department (M=38 min vs 149 min) yielding a mean difference of 111 min per encounter and a total time savings of 3762 hours. Conclusion Overall the drive-thru medical system was able to accurately triage patients presenting with potentially COVID-19 and to effectively treat lower risk patients, thereby reducing ED utilization. Although unconventional, drive-through medical systems are a viable option for surge healthcare delivery.