>CEO SUMMARY: What better way to limit the spread of a deadly novel coronavirus than to allow patients who suspect they have the COVID-19 illness to use a mobile phone to book an appointment with a phlebotomist who makes house calls? Northwell Laboratories started this service in November and now views this option as a preferred method of collecting naso-pharyngeal swabs and sputum specimens to test for the virus.
While traveling last year, members of the leadership team at Northwell Laboratories used a mobile-phone ride-sharing app to hail a taxi. The routine use of a telephone app to call for a cab prompted a discussion among those lab leaders about the possibility of allowing Northwell patients to use a similar app to call for a mobile phlebotomist.
“Almost immediately, we recognized this was a great idea,” said Dwayne Breining, MD, Executive Director of Northwell Labs. By the end of the year, Northwell Labs of Lake Success, N.Y., made the app operational across Long Island, throughout Westchester County, and all five boroughs of New York City. Then, just five months later, the world became transfixed watching news about the outbreak of a novel coronavirus.
Northwell’s lab team immediately recognized that their smartphone app and mobile phlebotomy service were ideal tools to help Northwell and its patients contain infections from the virus. Rather than risk patients spreading the illness to members of the public while traveling to a doctor’s office, to one of 23 Northwell hospitals, or to other patients in an emergency room or urgent care center, patients who suspect they may be infected can use the app or call Northwell to request a mobile phlebotomy visit, Breining explained.
For more than 10 years, Northwell Labs had offered a mobile phlebotomy service for homebound patients on Medicare and Medicaid. Therefore, the mobile app—called LabFly—became a natural extension for patients who would use a credit or debit card for payment, Breining added.
Patients can download the app from the app store on their mobile phones. For patients with commercial health insurance coverage, most payers will cover the cost of the lab test itself, but are unlikely to pay the $20 that Northwell charges to send a mobile phlebotomist to the patient’s home, he said.
In November, Northwell introduced the service in Brooklyn, Long Island, Manhattan, and Staten Island. In December, it launched the service in the Bronx and throughout its service area. By calling for a mobile phlebotomist, patients can skip a visit to the emergency room or a patient service center for a blood draw and other such specimen collection, such as the nasopharyngeal swabs used to collect samples from patients suspected of having the COVID-19 illness, Breining said.
“Whether it’s young children who are anxious about a blood draw, busy professionals, or someone being cared for, this app is a way to help fulfill patients’ needs,” he commented.
Since the app went online last year, some 28,000 people have downloaded it, leading to hundreds of home phlebotomy visits, he added. “We do a large volume of lab tests for patients in nursing homes and long-term care facilities, so the mobile phlebotomy service is always busy,” he said. “I estimate that we do somewhere around 300 or so home phlebotomy visits every day. “Patients who need mobile phlebotomy are those who are bedbound, or they’re being treated at home, or they simply can’t leave their house for whatever reason: medical condition or inconvenience,” he added.
“We already had a staff of mobile phlebotomists who could drive anywhere in our service area to get patients’ samples, which means we had the staff and the infrastructure in place.
App for Mobile Phones
“That made it relatively simple to set up the LabFly service,” continued Breining. Northwell contracted with a vendor to develop the app for mobile phones. Now it’s available from the Apple or Google store. “In this way, we’ve opened up our mobile phlebotomy service to the general public—meaning those who are not classified as ‘homebound’ by Medicare or Medicaid,” he said.
“Before we offered the app, we surveyed patients and tested the concept extensively,” Breining reported. “We live in a time when people are using ride-sharing apps, but also they’re routinely using apps like Grubhub to get take-out meals delivered,” he said. “Because they have that experience, they’re willing to pay a reasonable extra charge for the additional service.
“Sure enough, our surveys and concept testing showed there was a market—and, in fact, a lot of interest among patients—for having us come to them rather than require that they come to us,” he commented. “We already know that no one wants to go to a hospital emergency room or a patient service center if there’s a better option.”
Phlebotomy App Is Popular
Given that many people today prefer ease of use whenever possible, the Northwell Lab’s app for mobile phlebotomy became popular right away.
“Our LabFly app works in much the same way a patient would use a ride-sharing app like Uber or Lyft,” Breining added. “Patients pay a convenience fee to use our app just as they pay a fee for an Uber ride. The patient makes an appointment and enters a location in the same way too. The only difference is the patient needs a prescription or electronic doctor’s order for lab testing, but if he or she has that from the doctor, they’re all set.
“What surprised us was the satisfaction ratings,” he added. “People who used the app rated it overwhelmingly very good or higher. We knew it would be well received among a certain segment of the population. But we’ve actually been blown away by how positive the feedback has been. “Thinking back to when the idea was proposed, we considered it to be an obviously good idea,” he concluded.
“In retrospect, it was an opportunity that was sitting right in front of us since back when we started the mobile phlebotomy service. “That idea has even more significance given the outbreak of the novel coronavirus,” he added. “Our mobile phlebotomists generally do venipunctures and we can train them quickly to do sputum and nasopharyngeal swab collections.”
Contact Dwayne Breining, MD, at DBreinin@northwell.edu.