A Practical Look At How To Solve The Blood Supply Problem
Many people are familiar with food deserts—areas where it is difficult to obtain fresh, healthy food like produce and vegetables—but far fewer are familiar with blood deserts, places where blood supplies are scarce or even sometimes nonexistent. According to a recent article published by Harvard Medical School, "Billions of people live in 'blood deserts,' areas in which the clinical need for blood components cannot be met in at least 75 percent of cases."
A blood shortage could prove disastrous in life-threatening cases where a patient needs blood in minutes. Blood deserts aren't just located abroad; numerous rural communities in the U.S. don't have access to crucial blood supplies.
Many groups, including the Blood D.E.S.E.R.T. Coalition, have organized to combat the challenge. Hospitals and healthcare organizations, such as the Red Cross, have responded with additional calls for blood donations. While blood donations provide a crucial pipeline for blood supplies, they cannot fix the problem.
Emerging technology, hospital culture change and community activism, however, could provide critical help in the short term as experts work on systemic changes to boost blood supply in challenged areas. Experts say it will take decades to recover from the blood shortage in the U.S. alone. Here are four short-term strategies to adopt now to help address blood deserts.
1. Change the culture of thinking around transfusions.
Transfusions are a critical life-saving resource, particularly for victims of severe body trauma like industrial accidents and automobile wrecks. However, many have made strong arguments that transfusions are overused. In reality, transfusion is often unnecessary, and patients will do fine with their own blood. There are challenges to this, like longstanding medical practices. But when a transfusion is avoided, blood is saved for a patient who needs it.
2. Embrace patient blood management (PBM).
Four years ago, the World Health Organization (WHO) called for healthcare systems worldwide to implement patient blood management (PBM) as a standard of care. The adoption of PBM continues to lag, however, particularly in U.S. hospitals. In short, PBM is a systematic, evidence-based approach that improves patient outcomes by preserving a patient's own blood and promoting safety and empowerment.
PBM has three critical tenets: Use the patient's blood, minimize blood loss and improve a patient's anemia tolerance. Patient blood management has been transformative in conserving blood supplies at hospitals worldwide. The only challenge is changing the existing medical culture and protocols around blood use and transfusion. Hospitals should embrace the practice to increase blood supplies.
3. Adopt new technologies.
Technological advances and new tools may offer the best chance to help underdeveloped blood deserts in the short term. Chief among them are viscoelastic testing systems. These tests identify whether a patient is at risk for bleeding, the type of blood product they may require and the amount of blood needed. (Full disclosure: My company, HemoSonics, manufactures Quantra, a viscoelastic testing system.)
One of the most frequent causes of hospital trauma death is uncontrolled bleeding. However, many of these fatalities are potentially preventable with early, targeted hemostatic intervention. Some technological obstacles include the initial cost of purchasing the technology and training. However, according to the WHO, hospitals that implement viscoelastic testing find they quickly preserve blood, improve patient outcomes, reduce hospital readmissions and reoperations and lower hospital and healthcare facility costs.
Other new technologies could also make a difference. Zipline, for example, delivers blood and other critical medical supplies via drones from hospitals and urban areas to blood deserts in Rwanda. There are also 'walking blood banks': new backpack-size kits that contain everything remote medical personnel need to collect and then transfuse blood.
Finally, AI and machine learning are also promising: What they do exceedingly well is identify patterns and data and extract crucial findings about blood usage. The findings enable blood banks to allocate resources more effectively and earmark blood donations for underserved areas. AI can also help quickly match a patient with available blood supply, minimizing labor and ensuring patients receive the necessary blood product fast.
4. Utilize mobile blood collection.
When blood is collected, it is typically transported to a central site in an urban area for safe storage. Another promising answer to blood deserts is a more targeted use of blood donations. For example, patients in certain areas organize to collect blood for a remote hospital in need. Blood supplies could also be collected and then earmarked for geographic areas where supplies are scarce. Blood donors could also be identified and contacted during a critical regional shortage.
The existence of blood deserts is a multilayered social and economic problem that has as much to do with fundamental economic inequities as it does with medical practices. Truly fixing blood deserts will require economic development, improving transportation and supply chains and ensuring an equitable allocation of resources.
Nonetheless, the practices above shouldn't be considered just a short-term fix, but rather part of a collective effort to eradicate blood deserts. Combining technology, strategy, activism and public service is a major step in the right direction to conserve blood supplies and address the problem.
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