Is it possible to perform a blood test at home?

Tests that require blood sampling have long been restricted to labs. Dried blood spot (DBS) tests allow patients to submit samples to telemedicine labs rather than undergo an in-person phlebotomy procedure. Providers can mail dried blood spot cards to patient homes for population health programs, medication adherence, STI testing, and other routine screenings. Health plans and accountable care organizations can use dried blood spot card testing to complete quality measures for HEDIS and Medicare Star. 

What are DBS card tests?

Dried Blood Spot (DBS) cards utilize filter paper to absorb blood samples. Patients prick a fingertip to obtain capillary blood, which is then blotted onto the card. Each card contains five 13 millimeter circles, with each circle holding approximately 75-80 microliters of blood. The blood sample dries within a fibrous matrix and is subsequently shipped to a telemedicine lab for evaluation. In the lab, technicians extract the five spots by punching them out and elute them into a liquid solvent to isolate target analytes from the paper. Subsequently, technicians analyze the samples against markers to determine the test results

A paper on the Stability of Proteins in Dried Blood Spot Biobanks shows that the drying process does not impact the protein levels, indicating that the samples are still high quality. The study suggests a couple of other benefits that DBS offers over traditional wet sampling, including: 

• Greater comfort and convenience for patients: Only a small amount of blood needs to be collected, and it doesn’t require anything daunting like a needle in the arm. Additionally, since it can be administered at home without any help, it avoids the inconvenience of visiting a hospital. 
• Easy to collect and store: Since the samples are collected in low volume and on a strip of paper, the cost of storing them is very low. 

Is DBS card testing effective? 

A study conducted by the Department of Infectious Diseases, Odense University Hospital - Denmark, examined the specificity and sensitivity of DBS samples when testing for viral hepatitis and human immunodeficiency virus (HIV). The results state: 

• DBS has a sensitivity of over 96% when testing for both viruses. 
• The specificity of detection for both viruses was more than 98%. 

The study shows that DBS cards, combined with an automated analysis system, is a viable and efficient blood sampling method for pathological tests/study. 

What tests can dried blood spot cards run?

DBS cards can run many tests, such as screenings for STIs, diabetes, and Hepatitis. Public health departments often use DBS cards for population screening programs since street teams find it easier to transport cards rather than whole blood in a cooling unit. Health plans also use dried blood spot cards to meet HEDIS and Medicare Star requirements from chlamydia, diabetes, kidney disease, and other relevant verticals. Here are some examples of tests that can be run with dried blood spot cards: 

• PrEP/HIV: Patients use dried blood spot cards to screen for HIV every quarter and creatinine every six months to meet medication adherence requirements to stay on the drug PrEP. 
• HbA1c: Providers can order dried blood spot cards to patient homes to monitor and manage diabetes. The HbA1c test screens average blood glucose levels over a period of 2 to 3 months. 
• Heart Health: Dried blood spot cards detect levels of HDL, LDL, Total Cholesterol, and Triglycerides in the blood. Providers can catch cardiovascular problems to reduce overall costs and improve patient health outcomes.

How Ash Wellness uses dried blood spot card testing

The Ash platform does all the backend work so clients can utilize dried blood spot cards to access and screen their patient populations. The testing cycle with a dried blood spot (DBS) card involves several steps:

1. Collection: A patient pricks their fingertip to obtain a small amount of capillary blood. They then blot this blood onto the designated circles on the DBS card.
2. Drying: The blood sample on the DBS card is left to air dry, allowing the blood to be absorbed into the filter paper and forming a dried spot.
3. Transportation: Once dried, the DBS card is placed in a secure biohazard envelope for mailing to a laboratory.
4. Laboratory processing: At the laboratory, technicians punch out the dried blood spots from the card and elute them into a liquid solvent. This process extracts the target analytes from the filter paper.
5. Analysis: The extracted samples are then analyzed using various techniques such as chromatography or immunoassays. Technicians compare the results against predetermined markers to determine the presence or levels of specific substances in the blood sample.
6. Reporting: Finally, the laboratory generates a report with the test results, which patients can view within a secure portal. 

Ash Wellness offers 150+ kinds of diagnostic tests, including those run on dried blood spot cards. Providers can initiate remote care flows with tests for patients to perform at home, granting insight into hormones, medical adherence, allergies, and general health. The Ash platform lets clients launch national testing programs with a single API integration, including access to our trusted physician network, secure technology, white-label kitting and fulfillment, and CLIA/CAP lab network.