Could patients draw blood at home?

Blood draws are essential, but this doesn’t make them anyone’s favourite pastime: they are time-consuming and involve needles. Is there a way to make it in a do-it-yourself (DIY) fashion? Can we collect blood samples at home? 

While this method will be far from omnipotent for the unforeseeable future, it might have its merits. The pandemic highlighted how avoiding contact with a large number of random patients can be a wise idea. Besides, home-sampling of blood can provide a very efficient and convenient method for clinical trials, encouraging patient participation.

Let’s see the technology first. The initiatives we judge as trustworthy at the moment work along the same principles: they collect capillary blood from the upper arm with the help of a vacuum. After the preparatory steps, you stick the device to your arm, push the button, the suction creates a vacuum, microneedles/a tiny lancet pricks the surface of your skin, and in a few minutes, you have a small vial of blood.

DIY blood draw was recently used in a clinical trial evaluating the efficiency of booster shots. Instead of having to visit a health facility multiple times, participants used DIY kits at home and mailed their samples to the lab.

According to the available feedback on these devices, the process is less painful than a finger prick or venous draw.

Q&A for the most pressing questions

Apart from YourBio Health’s TAP II device that was used in the previously mentioned clinical trial, Tasso Inc. also has devices for liquid or dried blood sample collection. 

This new method of blood sample collection raises a number of questions, so we asked Dr Erwin Berthier, CTO and Co-Founder of Tasso about these. 

Is capillary blood a valid alternative to venal blood samples? Are there specific cases for yes or no? 

Capillary blood is accurate for most tests when the right care is placed throughout the process to ensure that the samples are transported in the right way and analyzed on trusted laboratory analyzers. We are always eager to share the data that Tasso and independent partners have collected to demonstrate the capabilities and accuracy of our technology.

Is there a guarantee (or validated statistics) for the diagnostic quality/value of the sample collected at home?

Both the Clinical Laboratory Improvement Amendments (CLIA)  and the US Food and Drug Administration (FDA) have rigorous testing standards that ensure the quality of the result returned in the USA. 

Can this sampling method cause hemolysis or hematoma?

We have spent 5 years improving the technology to chase all sources of hemolysis and are at a level today where hemolysis is not statistically different to that of venous draws in our studies. We have also worked on reducing all possible sources of bruising. However, this remains a blood collection process and on occasion, for some patients that are specifically sensitive to bruising, that can still happen.

Can the vacuum damage red blood cells?

Red blood cells are usually damaged by the shear forces when flow is forced through small openings, not the vacuum itself. We have worked on optimizing these parameters to reduce to the lowest possible level the amount of hemolysis.

One upside of DIY blood draw: saving time and inconvenience

One potential upside is pretty obvious: you don’t need to get ready, don’t leave the house, don’t have to wrestle your way through the morning traffic without having had a bite to eat or even a coffee. You don’t get bored (and possibly catch a virus) in a crowded waiting room, and there is no commute after your blood draw. 

Depending on the area where you live and the services you have access to, taking a blood test can take hours of your time, if you include travel and the waiting times – although the actual process takes less than five minutes. It is safe to assume that you are very lucky if the whole process takes less than an hour of your day, and are more likely to spend at least 2 hours or more with it. 

Consumer convenience has not traditionally been a factor taken into consideration – to safely draw blood you needed trained nurses or phlebotomists, and their capacities can be best used if they stay put and patients visit. Logical. 

So much so, that when I tried to find data about the average total time – including travel and waiting – it takes for patients to have a blood test, I couldn’t find any. Looks like nobody even cared about it. Obviously, until quite recently there was no viable alternative to going to the laboratory, nevertheless, it is interesting how the number one pain point of patients (spending hours to have a 5-minute test done) has never even been considered relevant enough to investigate.

Enter DIY home collection: it takes somewhere between 5-15 minutes. You wake up and basically finish the process by the time your toast and cappuccino are ready. While it wouldn’t cut down the time of the sampling process, it could spare you the travel and waiting times.  

Argument 2: Cutting the middlemen, protecting the data

Direct-to-consumer (DTC) testing is booming since the pandemic. What started as a necessity, quickly turned into real market demand. The reasons are manifold. 

The number of health-conscious consumers is on the rise: they want a more active role and more control in managing their health, thus they are happy to initiate and pay for specific tests that have been formerly only possible through a doctor’s order.

Also, we have insurance companies in the equation, that might/may not cover those specific tests, and whose coverage might (or may not) make the given test financially sound to the laboratory. Selling tests directly to the patients creates a simpler model – although not one without barriers. 

And there is one more important issue: confidential health data, that patients do not necessarily wish to share with others. DTC tests have one thing in common: the results arrive directly to the customer, who can decide if and with whom they are willing to share them.

While anyone could get their blood work done by ordering one of these kits, many medical tests will require a larger amount of blood. Also, most patients will still require assistance in interpreting the results. In that respect having a DIY blood collecting machine (or several, stacked on the shelf) will not create a brave new world, but – if nothing else – they could largely improve participation in clinical trials.