Needless needles

When your doctor orders blood tests, she may not know what she’s getting

One of the many inefficient things about the US healthcare system is the way it does clinical lab tests. Patients typically need to go to a blood collection center that is separate from their doctor’s office, where they must give separate vials of blood for different tests, which are then shipped to separate labs. Results can take a long time to come back. Reporting formats—the units of measurement used, and even which results qualify as normal or abnormal—differ from one lab to another, which makes reading the results tricky, even for seasoned physicians. The costs, and the possibilities of error, are high.

San Francisco startup Theranos wants to change that. The company revolves around new technology that allows clinicians to run 30 kinds of tests from a single drop of blood in no more than four hours. But another innovative feature is that the out-of-pocket cost of each test—the part the patient, as opposed to the health insurer, pays—is published upfront.

That may not seem like a revolutionary idea, but in American healthcare, it is. A survey published this week in the Journal of the American Board of Family Medicine found that more than half of primary-care doctors who order blood tests aren’t sure how much their patients will have to pay for them. Almost half were unsure whether insurance would cover the tests, and 40% were unsure whether it would cover tests at a particular lab; such uncertainties tie up doctors’, administrators’ and patients’ time in checking. And fully one-quarter suspected errors in the results.


Theranos’s technology not only speeds up and streamlines the testing process; it can also save some of the blood sample for follow-up tests so the patient doesn’t have to go back to give more blood. In fact, physicians can request that certain results trigger another round of tests automatically, so they don’t even need to look at the results first, thus removing another big source of delay.

However, Theranos testing is currently only available in San Francisco. And it might take some work to get doctors on board. Only around half of the respondents to the survey said that new information-technology services would make lab testing less confusing. Not surprising, as high-tech intervention has burned doctors before: According to a study last year, a system that sends doctors electronic alerts when a patient has an unusual test result caused information overload and led to their ignoring most of the alerts.

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