According to Beddard, blood centers have had an increased interest in collecting only the blood components actually needed for transfusion as opposed to collecting whole blood units. The process takes longer, but Beddard notes the ability to do this with a single rather than a double entry site makes it more comfortable for donors. The single needle donation technology was introduced to the market approximately six to eight years ago.
"Our donors realize that for their given blood type they are needed for a particular component," Beddard says. "It does take longer to donate in an automated fashion because you have to have an instrument that separates the blood components and gives back to the donor what they are not going to take. But our donors are very well-educated and dedicated."
Improved Testing and Storage
Beddard states that there has been significant development in the automation of blood testing for infectious diseases in recent years, as well as the ability to run multiple tests simultaneously.
"The newer trends in [testing] are to multiplex the tests and to do something that would allow you to have more real time testing results," says Beddard. She also envisions a future where nanotechnology and microcircuitry are built into bags that would allow blood banks to capture real- time information on the blood they manage. "It now takes 24 hours to get back the first testing results on a blood donation, and platelets only have a shelf life of five days," Beddard says. "That's 20 percent of the shelf life of the blood that we've lost waiting for testing. So there is a need to get more real-time results and get those results quicker."
AuBuchon believes new technologies are likely to emerge for improving blood storage with new additives for platelets or plasma. One company he has identified is developing an approach to storing red blood cells anaerobically in order to counter the negative effects of oxidation. If successful, improved storage technologies could prolong the life and improve the quality of blood products helping to boost the available, effective supply.
Beddard believes that one of the biggest areas of innovation in transfusion medicine has been the development of platelet additive solutions, such as Fenwal's InterSol, to lower the risk of transfusion-related acute lung injury (TRALI), allergic reactions and ABO hemolytic reactions among recipients of blood products.
"The top priority with technology companies serving blood centers is the platelet additive solution [for reducing the risk of TRALI]," according to Beddard. "A lot of them are working to decrease the amount of residual plasma to drive that risk down. The use of platelet additive solutions also reduces recruitment and collection costs since multiple platelet and plasma products can be collected from a single session."
Tracking and Traceability
Many phlebotomists are already using handheld portable barcode scanning devices to capture lot numbers on bag labels, start and stop times and other data. The process also allows for the electronic capture of donor reactions. Having this data captured electronically allows for easier transmission, more foolproof storage handling and easier analysis. As in many fields, blood banks are looking to adopt truly paperless tracking systems using RFID technology to avoid the need for barcode scanning. Blood bags equipped with RFID technology could allow for significant improvements in centers' ability to track donations through every stage of distribution to the healthcare providers they support. While the STB&TC is not using RFID tracking, Beddard says other centers are piloting the approach already.
"RFID, either passive or active systems, are being discussed but are not in blood centers yet," according to AuBuchon. "If Wal-Mart can keep track of potato chips with its RFID, why can't we do that with our red blood cells? There are some technical challenges, but they can be overcome. He envisions RFID readers throughout blood centers, hospitals and clinics that could identify a particular unit of blood as it enters a ward in a hospital reporting where and how it is used.
Improved tracking and traceability technology in blood banks will be critical in the future as the Joint Commission continues to work with hospitals to improve transfusion practices, including the selection of which blood products are appropriate for particular patients. A few leading blood centers are now piloting new web portals that allow the hospitals and clinics they serve to order the blood products they need online instead of telephoning in an order. The ultimate goal is to ensure that the right products are delivered at the right time to the right customer in order to maximize efficiency, lower costs and improve patient outcomes.
Remembering the Donor
Few areas of healthcare have undergone the same degree of automation in recent decades as blood collection and transfusion medicine, and this trend shows no signs of abetting. Despite this, Beddard stresses that the personal touches-attention to comfort and gratitude shown toward donors remain critical. In her centers 75- 80% of donors are repeat donors who give on average 1.65 times per year. In any field that relies so heavily on such a relatively small, dedicated source of suppliers, technology that improves the experience of those donors deserves closer attention. By focusing on the experience of these generous individuals, blood banks will be putting themselves into a better position to meet the growing demand for their services in the future.
Charlie Whelan (email@example.com) is senior analyst, Frost & Sullivan.
1. America's Blood Centers. 56 facts about blood. Available at: www.americasblood.org/go.cfm?do=page.view&pid=12. Last accessed Mar. 26, 2012.
2. Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, February 14, 2003 / 52(06);101-106.