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Phlebotomy Today

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April, 2016


New Startup Developing At-home Blood Tests

Shutterstock_140391409Bob Messerschmidt helped Google develop the Apple Watch. Now he's with Cor (San Francisco) developing a device that lets consumers test their own blood.

The Cor device is the size of an electric toothbrush, and utilizes disposable cartridges. The consumer obtains a blood sample by pressing the cartridge against their skin, then inserts it into a reader, which uses "patented vibrational spectroscopic technology" to analyze the sample for cholesterol, (total, HDL and LDL) triglycerides and fibrinogen. The results are sent to the cloud and after about five minutes, the user receives a report on his/her smart phone interpreting the results. With the exception of fibrinogen, the user does not receive the numerical value of the test result, but insights that guide them to make better choices in terms of supplements, diet and exercise.

Currently, the device is being tested by contributors to Cor's Indiegogo campaign. Donors are being asked to pay $149, which includes a three-month supply of cartridges. When launched, Cor expects to charge $299 for the reader, plus $10 per month for cartridges. 

Read a related article in TechCrunch.


Just in Time for Lab Week

OODPen_bannerNational Medical Laboratory Professionals Week is April 24-30.

If you're looking for an inexpensive but unique educational gift for your staff or students, put the recommended order of tube collection right at their fingertips. The Order of Draw pen is comfortable to grip and attractively illustrates the order of draw in full color on the barrel for easy reference.

Many studies have proven that when blood collection tubes are filled in the wrong order, test results can vary, sometimes wildly, from the patient's actual condition. Those who follow the prescribed order of draw collect specimens that are less likely to yield misleading test results that impact how the patient is diagnosed, medicated, and managed.

Reinforce the importance of the order of draw with phlebotomists, nursing personnel, medical assistants, the ED staff, and all those who draw blood specimens in your facility by putting this constant reminder in every pocket. The pens are available for immediate delivery in packs of 10 or 24.

For more information or to order.



Movers and Shakers recognizes individuals in the industry who are making a ruckus. Passionate visionaries, activists, and change-agents who are working to improve patient care by increasing the quality of blood samples collected and the caliber of those who draw them through innovation, education, legislation, and leadership. They do so tirelessly, often without any compensation besides the satisfaction of making healthcare better at delivering good health. 

  We first brought IGGBO to your attention in the July 2015 issue. Since then we've done significant research on their ambitions and find ourselves duly impressed...and we don't impress easily. In fact, we consider them true movers and shakers in the industry.

Founders Dr. Shaiv Kapadia, Nuno Valentine, and Mark Van Roekel launched IGGBO in spring of 2015. The company now operates in over 120 cities and has over 7,000 phlebotomists signed up. "We believe in connected, personalized medicine for everyone," says Valentine, co-founder and CEO of IGGBO. "How we do that is through on-demand technology. Our goal is to reinvent blood logistics."

Dr. Kapadia adds, "In the medical community we know that roughly 70% of healthcare decisions begin with a blood draw. Phlebotomists therefore have a unique opportunity to transform the entire healthcare experience one blood draw at a time. Our IGGBO phlebotomists are positioned at the forefront of this change and they are helping to accelerate healing for all patients."

IggboFoundersVerticalIGGBO connects phlebotomists with providers, health systems, and wellness programs in need of blood work for their patients, but don't have the means to perform the procedure themselves or could do it more efficiently using IGGBO's pool of independent phlebotomists. An estimated 30% of physician-ordered lab draws never take place. But IGGBO is averaging 98.2% appointment compliance. "IGGBO offers providers a way to quickly arrange diagnostic testing that can improve order fulfillment, health outcomes and patient satisfaction."

It works like this. Say a patient on blood thinner calls her doctor because she's noticed she's bruising more and bleeding longer than usual. She calls her physician who decides a protime needs to be drawn. Instead of making her come into the office, he places an order in the IGGBO system. This is where you come in.

As an "IGGY" (the informal name IGGBO phlebotomists are calling themselves) you carry a specialized iPhone provided by IGGBO with the app preinstalled. If you have a good customer rating and quality score, you receive a message seeking the services of an IGGY in the area. The first IGGY to accept the request receives information about the patient's location, what to draw and where to deliver the samples. It's like Uber, but for phlebotomists.

For patients, IGGBO ranges from free to inexpensive depending on the tests ordered. Some labs require patients to pay a small convenience fee for mobile draws that take place in a home or work environment. Independent phlebotomists working with IGGBO have full control over their schedule by accepting as many or as few appointments as they wish. IGGBO provides phlebotomists with ongoing training pertaining to each lab's requirements, a smartphone preloaded with the software, connections to suppliers, and professional services.

"The rewarding part of building IGGBO is that it gives phlebotomists an opportunity to elevate themselves in the profession while increasing their income and job flexibility," says Van Roekel. "We are turning phlebotomists into entrepreneurs." Many phlebotomists and nurses work full time jobs and set their availability on the IGGBO app during their off-hours to earn extra income.

"This is the future of phlebotomy," says Dr. Kapadia. "Using modern, on-demand technology, we can work together to remove current barriers in phlebotomy and unlock all of the potential for advanced blood diagnostics. For everyone, everywhere."

Become an IGGY!


Study Finds Low Compliance With CLSI Standard in Europe

Standard on blocksResearchers assessed compliance with the venipuncture standard (GP-41-A6, formerly H3-A6) published by the Clinical and Laboratory Standards Institute at facilities in 12 European countries. Twenty-nine provisions of the standardized procedure were assessed in the observational study conducted by the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for the Preanalytical Phase (EFLM WG-PRE).

Three-hundred thirty-six healthcare professionals were observed performing venipunctures in outpatient, inpatient, and emergency room settings. Half of those observed were nurses with the remainder comprised of laboratorians, physicians and administrators. Administrative staff performed venipunctures in outpatient areas only, whereas all other professions were equally distributed across all settings.

In the critical aspect of patient identification, the nine physicians observed were all compliant with the standard protocol. The 12 administrators observed were 75 percent non-compliant. Physicians did not adhere to test tube labeling policy 65 percent of the time.

Overall, the median error rate for the procedure was 27 percent. Among all observations, the two steps with the least compliance were inspecting supplies for their expiration dates (72 percent non-compliant) and assuring patients didn't bend their arms upward as a substitute for pressure (69 percent). Selecting a suitable venipuncture site had the most compliance at 99.7 percent.

Read the full article.


Product Spotlight: Boot Camp 2016

BootCampTransparent_200wOne person said it was the best seminar she's attended in her 35-year career. Another said the event gave her the courage and confidence to tackle a staffing problem. A third said attendance should be required for anyone training phlebotomists.

Hundreds of healthcare managers and educators from some of the most prestigious institutions around the world have graduated from the Phlebotomy Supervisor's Boot Camp since 2012. It's time you do, too. 

The 2016 Boot Camp will take place in Charlotte, North Carolina on November 8-10. Besides two-and-a-half days of intensive instruction, interaction and training, this year's event will have a special guided tour of Greiner Bio-One's state-of-the-art manufacturing facility in nearby Monroe where attendees will see how blood collection tubes are made.

Last year's event set a new record for attendance; we expect another sell-out this year. For the seminar agenda and more information, including registration options, visit www.phlebotomy.com/bootcamp. 


About your "open-door" policy

Interview skillsDo you close your office door when you don't want to be disturbed, or do you have an open-door policy? It's nice to be 100 percent accessible, but what does your open-door policy say to your staff?

If it says "I'm really not doing anything so important that it can't be interrupted by the least little thing," you will be. It also tells everyone up and down the ladder you're not working on anything that will move the needle. If you were, your door would be closed now and then so you can focus.

If your open-door policy says, "you can come in, but it had better be too important for an email or phone call," you'll likely get things done. 

If you don't have a door, but an open cubicle, you'll need to place some kind of indicator that tells passers-by whether or not you're open to interruptions. Employ a table lamp you can turn on when you're "open", a creative sign, or some other indicator that you can identify to your team as a signal of your accessibility.

If you don't have an office or you manage from outside an assigned space, you're a moving target. But that doesn't mean you can't have a "door policy."  To reduce the frequency of "stop-and-chat" interruptions, start using this phrase: "can you send me an email on that?" By deferring your attention to minor issues, you reclaim your productivity. It sends a signal that you are the one who gets to determine which interruptions are mission-critical.

It will feel awkward at first, but before long the non-urgent interruptions will dwindle and your emails will increase... along with your accomplishments.

Whether you have a door or not, everyone has a "door policy." Manage the policy and you move the needle.

Subscribe to the Empowered Healthcare Manager blog.


Survey Says: Continuing  Education

Blue target_croppedLast month we asked visitors to our web site and newsletter subscribers if they regularly participate in a formal continuing education exercise in phlebotomy, how frequently, and who provides the exercises. We conducted the same survey in 2008 and wanted to see if the trend is changing.

Do you regularly participate in a formal continuing education exercise in phlebotomy (i.e., one that measures comprehension of the exercise material)?

In 2008, 50 percent of those responding indicated they do, with 67 percent engaging in continuing education annually. The rest participated monthly. This time around, 76 percent of those responding participated in continuing education, half of them annually and the other half monthly.

Eight years ago, 62 percent found CE exercises on their own, whereas 37 percent worked at facilities that provided it for them. This year, 54 percent provide their own CE exercises.

Sixty-one percent of those responding indicated they always found their CE exercises valuable, Thirty-one percent found them valuable only sometimes. The Center for Phlebotomy Education was listed as the most common source of CE material (28 percent) with Healthstream (12 percent) and ASCLS (9 percent) coming in second and third. Certification agencies, product vendors, CEU Inc, MediaLab, Mayo Clinic, CAP, and "original material" collectively comprised 39 percent of the sources. Twelve percent didn't know where their CEs came from. 

For informal continuing education, i.e., without formal CE credit, the Center for Phlebotomy Education was the source for 45 percent of respondents. The second and third most frequent sources were product vendors and original material.

This month, were turning our readers and visitors into legislators by asking "If you could make a law affecting everyone who draws blood from patients, what would it be?" We're also turning it around the other way and asking what laws they'd apply if they could to the patients from whom they draw blood.

Take the survey.


What Should We Do?: drawing extra tubes

Question: I am the only phlebotomist in a cancer center.  With frequent transfusion patients, I will draw two large blood bank tubes, label them and set them aside in my rack. The doctor sees the patient and either orders blood, or does nothing. I am not sending, ordering, or doing anything with them until the doctor tells me what he wants. This is totally to avoid the "second stick" on patients who can be very difficult to get anything from. If there is not a transfuse order, I discard the tubes. Is it illegal to draw the two tubes?

Our response: There's nothing "illegal" about drawing extra tubes. Inappropriate perhaps, but not illegal. It would only be inappropriate if a venipuncture isn't necessary for other lab work that has already been ordered. In that case, you're not subjecting them to a procedure that isn't necessary.

Assuming a venipuncture is already required, the only issue would be whether or not it's against facility policy. One facility found drawing extra tubes on patients for lab work that wasn't ordered was costing them over $200,000 per year. They discontinued the practice after realizing only four percent of the extra tubes were being used.

Additionally, cancer patients who frequently require transfusions are already at risk for anemia. The practice of drawing extra "just in case" tubes of blood with each visit could actually cause iatrogenic anemia, which may then require the patient receive another transfusion. Transfusions are not without their potential risks, so drawing those extra tubes with the best of intentions could end up being harmful to the patient.

If you're performing a venipuncture just in case the physician places an order later, you could run into trouble should the patient be injured during the procedure (arterial nick, nerve damage, falls from passing out, etc.). The opposing attorney could successfully argue the procedure that lead to the injury was not ordered and wasn't necessary. 

Panelists for this month's column include:


Got a challenging phlebotomy situation or work-related question? Email us your submission at WSWD@phlebotomy.com and you just might see it as a future case study. (Names and identifiers will be removed to assure anonymity.)