Robotics combined with microfluidic systems continue to push traditional clinical laboratory testing and procedures toward physician’s offices and other point-of-care settings

Researchers at Rutgers University have developed a new venipuncture robot that can not only draw blood and perform medical laboratory tests, but also provide immediate analyses of blood samples at point-of-care locations, such as clinics, private doctor’s offices, and rural environments.

It’s a development that could give clinical laboratories new opportunities to support physicians. But, should blood labs, phlebotomists, and medical technologists feel threatened by this development?

“This device represents the holy grail in blood testing technology,” said Martin L. Yarmush, MD, PhD, Bioengineer and Translational Scientist, Professor in the Department of Biomedical Engineering at Rutgers University, and senior author of the study, in a news release. “Integrating miniaturized robotic and microfluidic (lab-on-a-chip) systems, this technology combines the breadth and accuracy of traditional blood drawing and laboratory testing with the speed and convenience of point-of-care testing.”

Dark Daily has reported on several “lab-on-a-chip” systems (or other types of “lab-on-a-” test devices) in past e-briefings. However, those devices for the most part are administered as part of procedures performed at clinical laboratories. Now comes a device that could make it feasible for doctors to perform some traditional clinical laboratory procedures in-office, while patients are still present. Such an innovation, if embraced, could impact clinical lab workflows and revenues.

The Rutgers researchers published their findings in Technology, an online scientific journal.

Rutgers Researchers Goal: ‘Nobody Touches a Needle’

Diagnostic blood testing is the most commonly performed medical test in the world, and the results influence most healthcare treatment decision-making. Traditionally, the success rate of manually drawing blood samples depends upon the skill of the clinician and the physiology of the patient. By locating the blood vessels before the venipuncture, the researchers expect their device to prevent stressful multiple blood-draw attempts, bruising, and injuries to arm nerves.

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“There are about two billion blood draws done in the U.S. alone each year,” Martin L. Yarmush, MD, PhD (above), Bioengineer and Translational Scientist at Rutgers University and senior author of the study, told Smithsonian Magazine. “It is the number one patient injury procedure. It’s also the number one clinical injury procedure. The device is meant to take over such that nobody touches a needle.” (Photo copyright: Rutgers University.)

The end-to-end tabletop device includes an image-guided robot for extracting blood samples from veins, a sample-handling module, and a centrifuge-based blood analyzer. The venipuncture robot works by first utilizing a combination of near-infrared and ultrasound imaging to locate blood vessels in a patient. The device then creates a 3D image of the vessels before sticking the patient with a needle to collect a blood sample.

The robot potentially could make it easier and faster to obtain blood samples from patients, particularly for patients where traditional blood draws can be difficult, such as children and the elderly.

“We wanted to create a device that would perform venipuncture procedure with little to no human involvement, thus minimizing human error,” Yarmush told Smithsonian Magazine. “As such, our automated device requires little to no training, allowing it to be easily adapted to any clinical environment.”
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The Rutgers venipuncture robot (above) contains a centrifuge-based analyzer capable of performing instant blood analyses, such as white blood cell counts and hemoglobin measurements. Immediate readings could mean that medical practices won’t need to send blood samples to a clinical laboratory for analysis. (Image copyright: Rutgers University/Smithsonian Magazine.)

Protecting Phlebotomists as well as Patients

The researchers also hope their robot could help prevent accidental needle sticks to phlebotomists. According to a study published in Mayo Clinic Proceedings titled, “Phlebotomists at Risk,” a hard-working phlebotomist may perform as many as 10,000 venipunctures annually. The median needlestick injury rate is about 1 per 10,000 venipunctures, so a dedicated phlebotomist could experience one accidental percutaneous blood exposure per year.

The researchers tested their prototype on “tissue-like” artificial arms containing tubes filled with blood-like substances. They hope to begin performing clinical trials on the venipuncture robot within the next year and aspire to establish other uses for the device.

“When designing the system, our focus was on creating a modular and expandable device,” Max Balter, PhD, stated in the news release. Balter led the study while a graduate research fellow at Rutgers. He is currently a senior research and development engineer at Medtronic. “With our relatively simple chip design and analysis techniques, the device can be extended to incorporate a broader panel of tests in the future.”

Such a device could provide valuable and rapid test results in emergency settings such as ambulances, emergency departments, and army medical facilities. The robot also would be a boon to rural/remote settings located far from a clinical lab, as well as regions that suffer from a shortage of trained medical personnel and critical resources.

A cost-effective, reliable phlebotomy robot could be a valuable asset for clinical laboratories in the future as well. However, were such a device to find a place in clinical care, it could reduce the demand for phlebotomists. It could also accelerate the trend of moving traditional clinical laboratory testing to doctor’s offices, clinics, and remote point-of-care settings.

—JP Schlingman

Related Information:

Automated Robotic Device for Faster Blood Testing

A Robot May One Day Draw Your Blood

Automated End-to-end Blood Testing at the Point-of-care: Integration of Robotic Phlebotomy with Downstream Sample Processing

Phlebotomists at Risk

Rutgers Researchers Develop Automated Robotic Device for Faster Blood Testing