Empowering labs through self-testing initiatives

Self-testing has emerged as a transformative approach in healthcare, particularly in managing chronic conditions requiring regular monitoring.¹ For lab leaders, self-testing not only streamlines operations but also enhances patient care, allowing labs to streamline operations and have a greater impact along the patient journey. 

As Operations Manager at Isala’s thrombosis center in Zwolle, Netherlands, we have been at the forefront of implementing self-testing for International Normalized Ratio (INR) measurements. As an advocate for self-testing, she has created innovative methods and results that can offer a compelling case for laboratories worldwide to consider championing such initiatives.

The lab plays a key role in driving self-testing. Having successfully trained over 1,000 patients annually to self-test, we have seen more than half of the center’s 4,000 patients adopting this method, which is a testament to the center’s commitment to innovation and personalized care.

Being early adopters, the center's integration with the hospital’s clinical chemistry laboratory has been instrumental in supporting and leading self-testing initiatives. The earlier patients engage, such as starting before they are discharged from the hospital, the smoother the transition to self-testing. Assigning each patient a dedicated thrombosis care consultant allows the center to further establish a strong support system that fosters trust, value, and accountability.

One of the standout strategies at Isala is the deployment of ambulatory thrombosis care consultants. These consultants are specially trained professionals who provide care through home visits or at decentralized meeting points. This eliminates the need for a central blood sampling clinic, reducing operational costs and enhancing patient experience through convenience.

Additionally, the center has streamlined its operations and improved interactivity with an online thrombosis care portal. Through the portal, patients can log their INR values, receive dosage updates, and share health notes, all of which improves patient care. While the development of an integrated app remains a future goal, this online portal already improves communication between patients and care providers.

Promoting self-testing can help laboratories empower patients and positively contribute to the overall healthcare system in a variety of ways, including the following:

1. Resource Optimization: With more self-testing, labs have a reduced workload leaving them with greater capacity to focus on complex cases.
2. Improved Patient Outcomes: Research has shown self-testing can reduce complications and lower mortality rates among patients.²
3. Enhanced Data Management: Real-time data from patients enables better monitoring and timely interventions, contributing to a more proactive approach to care.³

Laboratories play an important role, and the more efficient they can be, the better value they will contribute to patient outcomes. 

In the long run, self-testing leads to fewer complications.⁴ However, despite its advantages, the transition to self-testing is not without challenges. Patient resistance, particularly among older individuals, often stems from fear of change rather than practical concerns. One way to address this is by offering personalized training and incremental support.

Technological integration is another hurdle. Developing user-friendly apps to sync INR values automatically can further simplify the process for patients and laboratories alike. This level of self-testing enhances patient care by enabling real-time data sharing between patients and healthcare providers. Systems can be configured to generate alerts for clinicians when a patient’s INR levels fall outside predetermined parameters, for example.  By streamlining self-testing for patients, laboratories can further facilitate timely interventions and have a more proactive approach to treatment adjustments.

Laboratories have a pivotal role in driving the adoption of self-testing. It is only by embracing innovative models like those implemented at Isala, that labs can not only enhance operational efficiency but also significantly improve patient care. “My message for colleagues at other thrombosis centers still in the early stages of transitioning to self-testing is: visit us and see for yourself.”