A quarter of outpatients in hospitals receive service from blood collection units. This leads to overcrowding of patients and long service times in these centers. The increasing number of diagnostic tests and the aging population are the factors that will cause this number to increase even more.
On the other hand, in relation to the pandemic, it is known that the majority of infectious patients are asymptomatic patients. Therefore, electronic checking of current infections or fever measurements are not sufficient to identify infectious patients. New approaches are needed to provide large-scale blood collection services during and after the pandemic. It is estimated that the number of patients receiving ambulatory blood collection service per day in an average country is in the order of tens of thousands if not hundreds of thousands.
According to the scientific literature, there is a need to restructure blood collection services according to new conditions:
Conventionally, the service provided in a single center in the hospital should be spread over time and space and the formation of crowds should be controlled.
The patient's service waiting time should have a targeted upper limit. Patients should be able to access the most crowded and most available time information while receiving service and be able to decide accordingly.
The blood collection process of the patients should be carried out by contacting a single person. It should be organized in such a way that there is no need for the personnel who meet the patients, i.e. reception desk.
In terms of pandemic management, it is of great importance that tens of patients are not allowed to accumulate and wait for a long time in blood collection units, during this period when even classes of 40 people in our schools are considered to be a problem. Our PHLEROBO system is a unique and highly effective design with algorithmic, robotic and mobile elements that enables the restructuring of the blood collection unit according to the pandemic conditions.
At the heart of the system is an algorithm. This algorithm informs the assistive robots in the blood collection unit, the nurses responsible for taking the patient's blood, and the patients through appropriate channels. The algorithm monitors the performance of the given tasks and also measures the performances.
The algorithm optimizes the flow by using the parallels between the jobs it assigns, since there is no need for a human decision in the unit except in emergencies.
Next to each nurse, there is a personal assistive robot that selects the appropriate blood tubes for the patient, labels them and automatically presents them to the nurse when the patient arrives. Thus, it has become possible to use the time of human personnel labeling tubes in other units. The patient can receive service at a single point of contact.
With a mobile application, the patient was enabled to see the current and future load at the unit locations and to make reservations. The hospital can determine the number of reservations that can be taken according to the size of the area for each location. Thus, the service was spread over time. Kiosk applications, which are more conventional technologies, are also provided for patients who may have trouble using a mobile phone. Patients are guided by mobile application or LCD screens. The patient can register to the blood collection unit via the mobile application or via kiosk.
Through the PHLEROBO system administrator screens, the activities in the unit locations can be monitored real time and the recommendations of the artificial intelligence unit can be seen regarding the patient load. Thus, patients can easily receive service in smaller groups by distributing the service to different floors or locations instead of being provided in a single center. The opening of a new unit can be carried out on the same day, and the need for centralization in terms of financial efficiency has been eliminated, since there is no longer any need for people other than nurses to work in the unit. Thus, the need for the spread of the service in the space can be done at no extra cost and at great speed.
In conventional blood collection services, patients sometimes had to carry their own tubes. It was possible for infectious patients to infect these tubes and the infection would go to the laboratory in this way. Our system has completely solved this problem. Our system has started to be implemented in various hospitals and its effectiveness has been proven by our studies; In the same conditions, the duration of patient service times decreased by 3.4 times and the number of waiting patients decreased to approximately one third. It has also been observed that financial savings are achieved with the decrease in the number of working people.
1de Jonge, Niels, Herpers, Robert, Roelofs, Myriam and van Dongen, Edmée. "Blood sampling after COVID-19 − How to organize large scale phlebotomy services in the post SARS CoV-2 era" Clinical Chemistry and Laboratory Medicine (CCLM), vol. 58, no. 9, 2020, pp. e155-e157. https://doi.org/10.1515/cclm-2020-0671).
A project done at SBU Tepecik EAH, based on Phlerobo system, has been selected amongst the best practices list of Ministry of Health.