Home phlebotomy service to reduce the overcrowding in hospitals

Pol.Gen. Aswin Kwanmuang, Governor of Bangkok, revealed that Bangkok Metropolitan Administration (BMA) steps forward in developing system for home phlebotomy service with piloting service for Ratchaphiphat Hospital’s bedridden patients and will extend the service to cover other groups of patients of all BMA affiliated hospitals in the future.

According the civil registration, population of Bangkok isapproximately 6 million. However, about 8 million people have registered to health insurance coverage and other rights. From the survey of the patients under the care of Medical Service Department and Health Department, there are around 6,000 bedridden patients including some patients with metabolic syndrome such as diabetes, high blood pressure and hyperlipidemia.

However, the bedridden patients usually find it difficult to travelto the hospital. Their relatives or caregivers must hire vehicle to transport the patients to and from the hospital with the expense of not less than 2,000 Baht per trip. Consequently, the patients have high chance to miss doctor’s appointment in case that the relatives have difficulty bringing the patients to hospital. This includes the loss of income as a result from private leave to bring the patients to hospital. This leads to health problem whichalso affect the overall economic situation.

Many patients come to use the outpatient services of hospitals under the BMA Medical Service Department for approximately 4 million times/year, which is fairly large number.  It resulted in the overcrowding at service area of the outpatient department as there are people waiting for services at various service stations. The BMA, therefore, initiates variety of project to reduce the density of patients such as Telemedicine Project and Home Drug Delivery Project. However, there is still problem of overcrowding from people waiting for the laboratory test result for about 1 – 3 hours before meeting the doctor, especially bedridden patients with chronic disease who need stretcher for moving. As a result, their waiting usually needs large space.

In addressing this problem, the BMA formulates policy to reduce overcrowding and waiting time and the patients can stillobtain standard health care service. Mobile Laboratory provideshome phlebotomy or blood-drawing service so that the bedridden patient can have equal access to service. This canreduce waiting time of patient’s relatives and caregivers anddecrease congestion at the hospital. The pilot service is launched at Ratchaphiphat Hospital. Then, there will be an evaluation of each step in providing services, namely, drawing and collecting blood, and transporting blood to the lab in order to ensure the patients of the service quality before further extending this service to all BMA affiliated hospitals.

Governor of Bangkok added that the BMA has defined methods, formats and procedures for quick and appropriate home phlebotomy service as follows: 1) doctor considers which patients are suitable for home phlebotomy service; 2) hospital contacts the patient and/or relatives/caregivers inviting to use the home phlebotomy service; 3) in case that the patient agrees to use the service, relatives can contact the hospital to get “Informed Consent for Mobile Laboratory Service” Form and sign the form at the hospital; 4) patient who join the Mobile Laboratory project for home phlebotomy service can receive Telemedicine services on voluntary basis. In case that the patient intends to participate in both projects, patient and relative must sign the Informed Consent form before using services; 5) arrange an appointment with home blood-drawing service receiver; and 6) perform blood-drawing service at home and measure blood pressure from 06.00 – 09.00 hrs., and transport blood sample to the hospital’s laboratory within 10.00 hrs. in the same day for analysis. At any rate, a phlebotomist who draws blood from patients must be a health professional in medical technology and the blood sample must be analyzed by the hospital.

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