Patient-centered “Pre-analytics” in clinical laboratories
[*Editor’s Note: The
following is a guest blog post contributed by Biju Joseph, PhD, MT(ASCP),
Patient-comfort oriented specimen collection techniques are
vital for clinical laboratories for boosting customer base and revenue generation.
The workflow could be less invasive, less painful blood collection devices and
easy to use collection and transport kits. Multiple easy to use specimen
collection devices and application specific protocols are available in the
market. Pain-free, single use lancets for blood collection and mouth rinse
specimen kits for DNA isolation in place of buccal swabs are typical examples.
Saliva testing has been suggested for several cancers that
include breast cancer and prostate cancer. Clinical laboratories will be forced
to allocate time for switching to much more patient-friendly devices and
collection protocols as they are increasingly available due to the following
1. Home-based testing that was widely used for pregnancy
tests is being adopted for self-monitoring of hemoglobin level.
2. In the near future, patients will be able to self-order a
few tests to begin with, collect the results personally and could review the
results with help from their physician
3. Precision medicine initiatives by the federal government.
The general population will increasingly undergo genetic tests (on their own or
directed by physician) that would help healthy lifestyles, and create awareness
about susceptibility/resistance to specific genetic or infectious diseases. The
revolutionary nature of these changes is evident when we compare this to the
discovery of resistance of sickle red cells to malarial infection based on
clinical symptoms in the past
4. Changes in regulations (i.e., blood glucose monitoring),
re-classified as moderate complexity tests, necessitate use of devices that are
comforting to the patient.
5. Liquid biopsies are entering molecular diagnostics for
cancers due to inaccessibility or significant patient discomfort using the
In molecular testing, avoiding specimen processing for
nucleic acid isolation, though not directly related to patient comfort, could
contribute to guaranteed completion of test and report generation by direct
sample-to-answer testing. This also has potential applications in infectious
disease testing (limited nucleic acid material that could be lost during
extraction), significant time reduction in the generation of results and the ability
to detect multiple pathogens from a single specimen.
Franzmann. Saliva as a diagnostic tool. Special feature. MLO 2015: 47(7);24-25.