Feasibility of expansion of home phlebotomy with type and screen testing for hematologic monitoring: A single-institution pilot study.

Abstract

e13577 Background: Patients with hematologic malignancies require intensive supportive care, including frequent lab monitoring and transfusion support. Home phlebotomy has been shown to improve patient satisfaction and reduce healthcare utilization; however, current standards of care typically exclude type-and-screen (T&S) testing from home collection. As a result, patients require additional testing at transfusion visits, leading to delays in transfusion administration. This study aims to evaluate the feasibility, safety, and operational efficiency of incorporating home type-and-screen testing to streamline hematologic care. Methods: We performed a retrospective, single-institution audit of patients who had T&S collected at home 2x weekly with routine lab monitoring. Inclusion criteria included adult; transfusion-dependent hematologic malignancy diagnosis; enrolled in T&S pilot during period. Exclusion criteria included expired during period; absence of at least 1 home T&S. Data was collected via EMR and analyzed using descriptive statistics. Primary endpoints were feasibility ( > 80% same-day T&S processed) and acceptable redundancy ( < 20 % repeated T&S collection). Secondary endpoints were safety (transfusion-related adverse events) and efficiency (estimated transfusion waiting times as defined by time from patient arrival to transfusion start). Results: From 5/1 – 8/1/2025, a total of 212 home T&Ss were collected among 14 patients (n = 212; N = 14). The cohort was 36% male (5) and 64% female (9), age ranged from 28 – 86 years (median age = 68) and had 4 primary hematologic diseases: AML (10), ALL (2), MDS (1), and aplastic anemia (1). 201 of 212 (94.8%) T&Ss were processed same-day. 26 of 212 (12.3%) home T&Ss were repeated prior to transfusion visits. Of 212 total T&Ss, there were 163 subsequent transfusion visits, with 308 total transfusions (115 RBC, 193 platelets). Based on subset estimates, transfusion visit waiting times differed between standard-of-care and home T&S patients with a mean difference of 82.1 minutes (95% CI 39.1–125.2; p = 0.001). Regarding adverse events, there were 7 total transfusion reactions, of which none were serologic. 4 reactions occurred in patients who had home T&Ss. Conclusions: This retrospective pilot study demonstrates the feasibility of integrating T&S testing into home phlebotomy. Collection of T&S at home was associated with shorter transfusion visit wait times, demonstrating increased care efficiency, which may positively impact patient quality of life. Interdisciplinary care coordination is needed for patient selection, handling/delivery of lab supplies, and visit scheduling. Future research should explore patients’ experiences with home T&S testing.