Blood, bytes, and being a good neighbour

Wow – it’s been almost a month since my last post. My apologies for being tardy. I’m going through a bout of writer’s block, which isn’t a good thing for a doctoral student who wants to graduate 🙂 Regardless, I’m just going to write about my recent experience with the Canadian Blood Service (CBS).

This past weekend, I was in a local shopping mall and noticed a Canadian Blood Services booth. For reasons not completely apparent even to myself, I decided to donate blood. The experience itself was actually quite revealing. For one, the blood donating process is more technologically advanced than I had anticipated. Maybe it shouldn’t be considering the tainted-blood scandal of the 1990s (you can read a special on the tainted blood scandal).

Here are some things I noted:

  • Bar-codes. Anything that has to do with personal information or biological material gets barcoded. I wonder – would RFID tags be better?
  • Standardization. I was very surprised by the level of standardization of the blood-collecting process. Everything is timed using stop-watches/counters. Each donor gets her/his own kit with individually wrapped and prepared containers, swabs, and wraps.
  • Paper. While I was surprised with the bar-codes, I was also very surprised to see how much information is still collected using paper and pen.
  • Human Touch. The nurses (or more correctly phlebotomists) provided a very humanizing element to the entire experience.

Okay, those are some of the things I noticed right away. I’m actually interested to see how my “information” is used. One of the nurses with whom I spoke mentioned that the Canadian Blood Service has a national system (except for Quebec which has its own system), so that I can go anywhere in Canada and donate blood. I’m supposed to receive some sort of identification package in the mail in a few weeks identifying my blood type and some other details I can’t recall.

One thing that I intrigued me was the level of complexity of the consent form as well as the intake questionnaire. I can’t understand how someone who has difficulty with English could possibly understand the form. Maybe that’s why a nurse verbally confirms all of the responses before allowing someone to proceed. I was mildly surprised to note that all donors have an opportunity to voluntarily withdraw just prior to donating blood using a “yes/no” sticker system while alone in the “room”. The nurse said that this procedure gives the donor a final “out” if the donor has any reservations about donating – either because they are afraid of the procedure or have concerns about their own eligibility for donating blood.

In terms of the actual blood collection itself, it wasn’t so bad. I was shocked to learn that 450mL of blood is collected (about two small cups). The blood collection only took about 15 minutes, but I spent about 50 minutes for the entire process. I was a bit disappointed because I was initially led to believe that I would only need 15 minutes, but maybe I didn’t ask the right question – how long before I can leave versus how long does it take to donate blood?

As I was lying on the cot with the tube sticking out of my arm, I was wondering if there was any opportunities to automate the process further. The only thing I can think about is having an electronic intake form. But, an electronic form means significant investments in technology with what may be very little gain. The form itself isn’t the problem. It’s having some hardware that donors can use to enter the information. Could a handheld computer be used here? I’m sure that using electronic tools could provide multi-lingual support for non-native English speakers. Part of the challenge is that much of the blood collection takes place outside of the CBS offices (e.g., malls, schools, and community centres). What type of infrastructure support would be needed to make an electronic solution work? I saw a few laptop computers that the desk clerks were using, but very little by the nurses/phlebotomists themselves.

I think the nurse is right to note that asking people in person and observing their responses is a good human check to make sure that potential donors are being truthful in their responses. Being from a research background, I was mildly interested to see that CBS encourages donors to participate in research (by collecting a small portion of their blood for testing and research projects).

Oh yeah, one last thing. One of the “experienced” donors waiting beside me commented how the entire process seems to be getting longer each year. He thinks that the time will only increase because of the increased bio-terror threats. I was shocked to hear this idea, but after some thought, I realized that attacking the health system maybe a natural escalation of terrorists with the blood supply only one just insidious method. Scary thoughts…

Well, I’ll write more in two months during my next blood donation. I’m curious to see if the information they collected from me will be used. Hopefully there will not be as much demographic data collection.