Labs Use IoT Tools for Specimen Logistics

For Interpath Laboratory, tech improves tracking of specimens and offers new quality measures


CEO SUMMARY: Internet of Things (IoT) devices have proven adept at managing logistics, and BoxLock uses the technology to help clinical labs and pathology groups monitor pre-analytic specimen collections. Interpath Laboratory also has found IoT tools to be beneficial in providing greater accountability during specimen pickup and improving customer service. 

THERE MAY BE NO GREATER RISK TO CLINICAL LABORATORY CUSTOMER SERVICE than a specimen that goes missing on the way to a lab. The problem raises questions about ineffective processes, inconvenienced patients, and delays getting test results to the referring physicians. 

To prevent these problems in the pre-analytic phase, some medical laboratories and anatomic pathology groups are turning to Internet of Things (IoT) devices to collect and track data on lab-bound blood and tissue samples. 

IoT refers to the idea of interconnected tools that use the internet to stay in touch with each other in real time. The technology has proven useful in logistics environments, such as lab specimen collection, because it uses data to fill in areas of uncertainty along a supply chain. 

“The space between taking a specimen and the point it arrives at the lab is often like a black box,” said Brad Ruffkess, CEO and founder of BoxLock. “The loss of lab specimens correlates with increased healthcare costs and timeliness in receiving the specimens at the lab.” Ruffkess was speaking at the 2021 Executive War College, in the session “Internet of Things Comes to Clinical Laboratories: Using a Smart Lockbox to Improve the Integrity of Specimens from Client to Lab, While Documenting Time, Temperature, and Other Factors.” 

IoT Tracks Specimen Data 

BoxLock, an Atlanta-based company founded in 2017, offers supply chain access and control devices to healthcare, aviation, and other industries. It serves clinical laboratories with a pre-analytical specimen logistics solution using IoT devices that connect to each other and with systems over the web to provide data. 

The company is named for its bright yellow smart locks, which labs can attach to any brand of specimen container. As IoT devices, the locks are embedded with barcode scanners and use cellular connectivity to exchange data with other systems and devices. 

Additionally, the BoxLock platform offers access control, inventory information, and route management. Integration over cellular networks for environmental conditions in the specimen container during transport is accomplished via Bluetooth sensors. Related data is available to labs in real time in the cloud. 

The idea behind this specific IoT technology is to keep blood and tissue specimens secure and monitored from the time they are placed in the container and picked up by a professional driver to when they arrive at the lab for accession, test performance, and reporting. “In healthcare, there is a huge focus on specimen control,” Ruffkess said. 

With BoxLock and similar IoT platforms, lab staff can review the full chain of custody of a specimen, from the time it is placed in a collection box to when the specimen is accepted by the lab. 

“It’s detailed and quality information,” Ruffkess noted. “The lab gets a robust picture of the quality of specimens.”

These statistics suggest more reasons why labs may want to consider a specimen logistics solution, according to BoxLock:

  • More than 13 billion specimens are collected annually in the U.S., according to pre-pandemic data from the American Association for Clinical Chemistry.
  • Pre-analytic errors may account for up to 87% of lab errors, as documented in a 2017 case study published by the U.S. Agency for Healthcare Research and Quality.
  • The loss of just one specimen costs a lab an average of $548, according to a 2016 study done by Northwell Health in New Hyde Park, N.Y., as reported by Medscape Medical News.
  • More than 30% of lab pick-ups by drivers have no specimens in the containers, increasing costs, according to BoxLock customer and partner data.

Lab-Bound Specimens

Those numbers illustrate the direct and indirect costs that can occur during the transport of specimens to the laboratory. “There is substantial risk during that pre-analytic time, even if the number of errors or mishaps is not high. It’s where errors can and do occur,” Ruffkess added. 

“The BoxLock product records the time specimens were placed inside a container, notes how many specimens are present, and alerts drivers if no specimens are to be picked up,” he explained. “Use of this type of data benefits labs through escalated customer service, improved test turnaround time, and potential decreases in logistics costs of up to 30% if previously wasted stops are eliminated.”

Interpath Lab’s Success 

Interpath Laboratory in Pendleton, Ore. has been using BoxLock for about one year with goals of tracking processes better and gaining more insights and data about its extensive routes and specimen transport. The privately-owned clinical and anatomic pathology lab has a fleet of more than 100 vehicles covering more than 10,000 miles daily. 

Interpath has a wide network of patient service centers and testing facilities in addition to its main lab in Pendleton. It also works with physician offices, hospitals, and other providers. 

“My task is to make sure we do not lose samples,” said Tyler Kennedy, Logistics Manager at Interpath and its sister consulting company Adaugeo Healthcare Solutions. “We’re good about picking up samples from our locations because we know what samples are produced at that location. But when it comes to going to a client’s office, if we don’t interact with them before the pick-up, we’re pulling specimens out of the box and hoping for the best with the samples.

“If a client says, ‘We put out five specimens at 5 p.m.’ and we come by at 5:30 p.m., we expect to pick up five samples. If there’s discrepancy, we have to figure out why the sample is missing,” he added.

Working with BoxLock allows Interpath to provide more accountability in specimen collection processes, including any gaps in service. “The majority of time when five samples go in a box, five samples come out,” Kennedy observed. “Sometimes a sample remains inside, and when that happens, we know we have corrective actions we can take. Our clients have more trust in us knowing we are able to grab that data. It gives us better service to roll out. We can say to clients, ‘We have quality measures that we’re working on.’”

Environmental Monitoring 

For environmental monitoring of specimens, BoxLock partners with Parsyl, a Denver-based insurer of supply chains and provider of single-use temperature trackers and long-lasting multi-sensors. The single-use trackers help monitor critical specimens, Ruffkess noted.

IoT devices from BoxLock and Parsyl integrate to monitor and protect specimens from decreasing in quality due adverse weather conditions, for example.

“We use cellular connectivity on locks and Bluetooth sensors to read environmental conditions within the specimen box. The devices capture the current environment and log each time that box or specimen has crossed thresholds. From the time the box was opened until the courier picked it up and it arrived back to the lab, we know what the conditions of shipment were like,” he said. 

Clinical laboratories looking to gain an edge on competitors while also protecting their clients should consider IoT and other data-rich technologies that improve security and monitoring of specimens during collection and transit.

Contact Brad Ruffkess at 678-800-1269 or; Tyler Kennedy at

How IoT Connectivity Helps Clinical Laboratories Monitor and Streamline Logistical Workflows

CONNECTIVITY PROVIDED BY IoT DEVICES can be used by labs to monitor lab environments, instruments, and inventory as well as streamline workflows, and “provide assurance that equipment and processes are running smoothly,” according to Labcompare, an online buyers guide for lab equipment. 

“IoT devices collect data about the physical world and make [this] data available in the cloud,” said Brad Ruffkess, CEO at BoxLock. “When a driver walks up to the box, BoxLock enables scanning of the specimens. The driver will already know how many specimens are expected inside the box,” he explained.

Here’s how the IoT devices operate:

  • Devices: Locks are integrated with barcode scanners and include real-time connectivity to protect and track assets worldwide. They work with Wi-Fi, cellular connectivity, and Bluetooth for environmental sensors. No software application download is required.
  • Platform: Software features include access control, audit logs, and inventory management.
  • Tools: Cloud-based application programming interface (API), real-time notifications, and software development kits (SDKs) that support a lab’s workflow are among the options labs can use.

Access to the data is possible from a hand-held device, employee badge, or barcode on the specimen label. Also, route management features from BoxLock can integrate with a laboratory information system.

“We can do an automated pick-up request at the time a specimen is scanned in. BoxLock can also send notifications to a clinic or practitioner to inform them that the lab’s cut-off time is approaching. 

“So, for example, if the lab hasn’t seen a specimen by 2 p.m., and the cut-off time is 3 p.m., the clinic will receive a one-hour warning to prevent them from missing the opportunity to have the lab pick-up within the confines of that day,” Ruffkess explained.



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