This Community is Archived.

While this community is no longer active, we invite you to review and recommend past posts and resources. Membership for this community is closed, but we hope you'll join us in one of the many other communities on GHDonline.

Moderators of Technology for Patient Engagement and GHDonline staff

Idea Faster, more affordable lab testing

By Sue Houck | 02 Dec, 2014

Having survived a life threatening illness, worked as a primary care provider and facilitator of care transformation with hundreds of primary care providers and hospital systems and authored a book on redesigning primary care, I laud your effort here.

I would like to submit a new technology breakthrough of faster lab testing that requires drops vs. vials of blood at less cost (posted on their website) than Medicaid reimbursement. While there may be other companies providing the technology, currently Theranos (with whom I have no professional or personal relationship) is making inroads in California and Arizona via retail pharmacy testing. They also have contracts with UCSF and several other large healthcare systems.

86,000,000 Americans are pre-diabetic, 90% of whom don’t know they have it. If given ready access to lab information only 5% of these folks improve their diet and lifestyle would this not improve engagement and reduce costs?

Since 70-80% of clinical decision making is based on lab results, lower lab costs make ongoing vs. episodic monitoring to engage with patients and improve health far more viable.

As with other innovations, the activated, engaged 18-20% of patients may initially embrace ongoing access to lab information to better engage with providers and their own health. But, perhaps like the diffusion of ATMs, over time the innovators and early adopters will lead the majority to more active engagement in their own health and care.

Keywords:
 

Andrey Ostrovsky Advisor Replied at 1:38 PM, 3 Dec 2014

Googling "fast lab results" and "startup" will reveal several companies that are tackling the issue. The speed element is being solved. The cost element is still a challenge but may be addressed by either offering 1) large distribution volume whereby even low-resource settings can offer an interesting financial incentive to sell high-volume low-cost tests, and 2) brand equity for companies trying to build a reputation on "doing the right thing". There is also a growing movement to test transdermally without needing blood, which may be an opportunity to improve speed/cost.

Marie Connelly Replied at 3:36 PM, 3 Dec 2014

Many thanks, Andrey—appreciate your thoughts on this topic!

I think the Ebola outbreak has really crystalized the importance of strong lab capacity, and highlighted the need for faster lab results in a variety of settings. It's seems like there's significant potential here for resource limited settings—I'd be eager to hear more from our Advisors and members here on what it would take to realize that potential.

Jordan Harmon Advisor Replied at 11:05 PM, 3 Dec 2014

Thanks for the idea Sue. I think lab testing is definitely an area with a lot of opportunity for innovation and improvement. I agree with Andrey, I think there are many startups and other organizations looking to tackle this issue, especially because of the dollar value attached to finding a good answer. One example includes a company that is developing a very low cost (Less than $1 US) testing paper for third world countries in order to eliminate delayed results and rather provide real-time effective answers.

I think one of the biggest issues I've seen with labs and technology is the lack of integration and communication to the care team to make real time decisions. Also, I think that there is a lack of at home technologies that patients can utilize prior to visiting a physician office. I would suggest that focusing on building a technology that allows patients to take ownership of certain labs and upload results to their physician prior to visiting the doctor to confirm.

Maxim Topaz Advisor Replied at 11:40 PM, 8 Dec 2014

What an excellent pot Sue- thanks for this idea! This issue raises several important policy questions. For example, if one-third of Americans are pre-diabetic, and it will be clear from the blood drawings and rapid labs, what is the role of insurers/government? One one hand, a logical suggestion would be that everybody engage in regular exercise and stick to health diet, though it is hard to create incentives for real adoption of healthy life style. It looks like innovations like the one you suggest would urge health systems in the US to figure out the so-what-do-we-do-now part of the question... Thanks again for the great topic!

A/Prof. Terry HANNAN Advisor Replied at 2:47 AM, 9 Dec 2014

Sue, I am very pleased you have posted this topic. RAPID LABS is here to stay and will get even better. This will be a great enhancement in care delivery however there are some possible caveats.
Even with some systems providing patients with easy access to lab results we need to ask "are they changing the outcomes of care?" Existing evidence probably indicates no.
So Pre-diabetics/diabetics or other "environmentally preventable diseases remain on the increase". Why it can be stated that outside the "health care delivery doors" there are some very large anti-health armadas that repeatedly completely undermine many care protocols.
Please see the attached selection of slides that highlight our problems. [The file did not upload so I will get Marie Connelly to post it.]
SOLUTIONS to these MUST be found.

Austin Walters Replied at 3:55 AM, 9 Dec 2014

Sue, thanks for posting on this topic, and all for the comments. I'm thinking more about this from a global medtech perspective. Where the goal is to make testing affordable in the U.S., the goal in certain parts of the world is to provide first-time access to basic testing, with interesting results: India recently pioneered a portable PoC tablet that can perform 30+ IVD and other tests for patients. It costs ~$800 to manufacture, all accessories included. I really think this kind of technology w/ concomitant novel delivery models, is the key to lowering costs for testing globally, including in the U.S. We also have a forthcoming post on the Aina Device from Jana Care in India just for Diabetes management, but same principle.

Article is here: http://www.globalhealth.care/2014/12/indias-new-health-tablet-performs-30.html

A/Prof. Terry HANNAN Advisor Replied at 6:38 AM, 9 Dec 2014

This may be an entirely irrational posting however the preceding discussions activated in my mind the following ideas.
I read with great interest the short dissertation posted by Autin about the Theranos lab testing system. India's New Health Tablet Performs 30+ PoC Diagnostic Tests [Theranos] Saturday, 6 December 2014
It demonstrates the unlimited potential for e-technologies in health care and for many of us there is an altruistic desire to use these effectively. The reference to the cost effective development of health resources in countries like India reminded me of the pervasive influence of some developers’ e.g. pharmaceutical companies, that dollars and not altruism is the name of their game.
This was highlighted in the initial screening of a film I saw in New York in 2013 that related to the development of cheap anti-retrovirals for the sub-Saharan HIV/AIDS epidemic.
This film was close to my heart because of my original work there on this epidemic and some of the people in the film I had met.
I am unclear why I felt the need to post this to these discussions but health costs and the availability of health resources are critical in low and middle income nations. If a countries annual net income is $390 US / annum and the medications cost $300US/m them we all have a problem.
Based on the following information the film is downloadable for educational and other purposes.
Web information.
Fire in the Blood: https://vimeo.com/ondemand/fireinblood
Please note: Rental and Purchase of FIRE IN THE BLOOD is offered here for **Personal/Home Use Only** // Individuals, groups and institutions wishing to screen the film for educational and other purposes should use the form at fireintheblood.com/contact to enquire about doing so.
One of the most internationally-acclaimed Indian films of recent years (and the longest-running nonfiction film in the history of Indian cinema), FIRE IN THE BLOOD is an intricate tale of 'medicine, monopoly and malice' which tells the story of how Western pharmaceutical companies and governments aggressively blocked access to low-cost AIDS drugs for the countries of Africa and the global south in the years after 1996 - causing ten million or more unnecessary deaths - and the improbable group of people who decided to fight back.

Sudip Bhandari Replied at 3:56 PM, 9 Dec 2014

Here is a resource (attached below) that is in conjunction with the previous comment by Terry.

Attached resource:

This Community is Archived.

While this community is no longer active, we invite you to review and recommend past posts and resources. Membership for this community is closed, but we hope you'll join us in one of the many other communities on GHDonline.

Moderators of Technology for Patient Engagement and GHDonline staff