Valerie Neff Newitt
March 2023—The need was always there for some. For others, it’s a matter of convenience.
“Home phlebotomy as a concierge service” is how Michael Eller describes what went live in 2019 in New York at Northwell Health, where he is assistant vice president of business development for its laboratories. “It was just a matter of using the capacity we already had in the field and hiring appropriately as needed,” he says.
Northwell’s mobile phlebotomy unit that had long performed the blood draws for nursing home residents and others who are homebound developed LabFly, the concierge service application, available for download from the Apple iTunes store and from Google Play for Android users. “It’s similar to Uber and DoorDash, where patients can register, put in their insurance information, their demographics, and schedule a home blood draw for the next day, for which we charge a $27.99 convenience fee,” Eller says. The mobile unit also collects nasopharyngeal swabs for COVID testing and retrieves urine and stool samples after patients have collected them—to be tested at Northwell Health.
Feedback has been positive, especially from parents, he says. “We’ve had stories of children who are afraid of needles. Our phlebotomist comes into the house where the child is sitting on a couch with a blanket and stuffed animal. It’s a calming experience,” compared with the “much more clinical” patient service center experience.
Some among the older population of patients are not homebound but they are less mobile than they once were. Now a phlebotomist can come to them. “It’s been the younger population, too, who are out and about with work—the business people. I’m a good example: I work in a laboratory, but I still have trouble finding the time. I use LabFly and they come up to my office and draw the blood in my office.” Workplace draws are common, he says.
New this month is the desktop version of LabFly, which makes it possible for physicians to order a LabFly draw for their patient at the time of the office visit. The hope is that this will increase compliance for blood draws from patients who don’t use apps and might otherwise skip the ordered blood draw because it’s inconvenient. “Now we’re giving patients another option,” Eller says. Northwell can be proactive, too, by pulling data to see who the patients are with illnesses and for whom the mobile service would be helpful.
The third-party company that developed the app, MphrX, later developed the desktop version.
LabFly has a patient portal for the results of those who use the app. Beginning this month, that portal will be usable, too, by those whose blood is drawn at any Northwell hospital or patient service center.
What the mobile phlebotomy service does, Eller says, is distinguish Northwell in the marketplace. “It’s expensive to send the phlebotomist out to a patient to draw a basic blood test when you look at reimbursement. We’re a health care company—we look at it as a service that improves the health and the care of the patient, and it differentiates us in the marketplace.” The mobile unit does about 1,500 at-home draws daily, which includes the nursing home draws.
To add to their numbers of phlebotomists, during a time when the shortage reached crisis levels, Northwell in 2020 purchased Apex, a small laboratory that specialized in home phlebotomy. “Through that purchase, we were able to add about 70 or so phlebotomists into our workforce to help with the demand.”
Even at the height of the pandemic, Northwell’s phlebotomists continued to enter homes to draw blood. “It was just incredible,” Eller says. “I spoke to phlebotomists who went into homes in Brooklyn full of eight people, and every one of them was coughing. Some laboratories closed their sites, but our phlebotomists ran into the storm.”
Expansion of the service is in the plans—to encompass in-home laboratory testing. “We definitely see it as the wave of the future. Our vision is that if a patient needs laboratory work, we could pull up with a small truck and perform 80 percent of the work they need onsite at that moment.” The convenience and the speed of getting results to the doctors are part of a larger vision, he says. “You have a telemedicine visit. You get your work done at home. That triggers the physician to order your medications, which are delivered by our mobile pharmacy. So you can receive all of your services at home.”
[dropcap]G[/dropcap]etlabs, too, is serving not only patients who need at-home blood draws but also those who want it for convenience in the workplace or elsewhere, says Dennis Ernst, MT(ASCP), NCPT(NCCT), senior quality advisor and clinical educator at Getlabs. “It’s those who are healthy and seeking wellness and they’re able to get up and go. They just don’t want to, and they love the convenience of the lab coming to them.” Others aren’t feeling well and prefer not to get in a car and sit in a waiting room. Getlabs’ customers, who don’t need a physician referral in states that do not require it, don’t fit a specific patient profile, Ernst says. “It benefits a multitude of different patients for different reasons. It’s a matter of convenience as well as a matter of need. It’s both.”
Work on the Getlabs technology platform was underway a year before the pandemic began, and the company was “in a perfect position to meet the moment,” he says.
The patient goes to the website (getlabs.com), selects a time and date, and uploads their order, “and we connect the dots from there,” Ernst says. “We assign them to a phlebotomist in their city as early as the next day. We have several communications with the patients in advance: ‘Your phlebotomist has been dispatched.’ ‘Your phlebotomist is 10 minutes away.’ And we just show up. They’re given instructions about fasting, if that’s necessary. All very user-friendly.”
The samples are centrifuged in the field and delivered to the laboratory of the patient’s choice that same day. “If it’s a stat order, we deliver the samples immediately.”
For laboratories like Quest and Labcorp, Getlabs is providing “that final connection, that pocket of consumers they can’t otherwise reach,” Ernst says. For partners, the technology platform and services are customized to their needs. Getlabs founder Kyle Michelson partnered with Labcorp, which is both partner and investor, from the start, beginning in 2018. The company, based in Miami, Fla., serves 35 markets in 18 states.
One of Getlabs’ challenges, Ernst says, is “finding the best phlebotomists in the industry.” With an estimated 150,000 phlebotomists in the country, it takes an innovative approach to find those who meet the company’s stringent requirements and are looking for a new opportunity, he says. Currently, they don’t train “from the ground up”; they hire only those with at least a year of experience. One of Ernst’s jobs is to help “engineer quality” into hiring and onboarding. “That requires me to develop and distribute educational materials internally and help coordinators implement them.” The ultimate goal, he says, is to “find the best, empower them, and keep them happy.”
Getlabs is accustomed to overcoming obstacles, he says. “What was just an idea four short years ago has met and overcome a multitude of challenges that could have stopped us cold had we not been determined to succeed and attracted the caliber of talent necessary.”
As Getlabs grows, Ernst says, it becomes increasingly clear that such services are needed, “beyond simple blood and urine samples. We’re going to move into those markets as they become more viable, more popular, more necessary, to increase the continuity of health care.”
What can be done in a patient’s home “is limited only by imagination and technology,” he says. “So we’re looking at all possibilities.”
Valerie Neff Newitt is a writer in Audubon, Pa.