Six-month trial program seeks to speed test turnaround times and increase patient safety
Hospitals around the world are increasingly employing drone services to deliver laboratory samples and medical supplies between clinical laboratories. One such six-month test program in the United Kingdom (UK) has drones quickly and efficiently transporting blood samples between Synnovis’ lab at Guy’s Hospital and the lab at St Thomas Hospital through the skies over London.
The medical centers are part of the Guy’s and St Thomas’ NHS Foundation Trust, which has five hospitals, including two of London’s most famous and prestigious teaching hospitals.
NHS partnered with healthcare logistics company Apian and Wing Drone Delivery, a global entity that’s part of Google’s parent company Alphabet, for the six-month drone-delivery trial.
The medical drone service currently delivers blood samples from patients who are at a high risk for complications from bleeding disorders.
Traditionally, delivering blood samples by road between the two locations takes about 30 minutes, depending on traffic. But delivery by drone between the two laboratories takes less than two minutes with the added benefit of decreasing carbon emissions and reducing traffic congestion.
And drone delivery allows for faster analysis of samples, which expedites test turnaround times and helps physicians more quickly determine if patients are safe to undergo surgery.
“This drone trial to deliver blood samples should speed up test results for some of our most vulnerable patients, ensuring they have the very best care,” said Lawrence Tallon, deputy chief executive of Guy’s and St Thomas’, in a news release. “It combines innovations in healthcare with sustainability to give us an NHS fit for the future.”
An NHS drone in flight over London passes by Big Ben. Total flight time is about two minutes, as opposed to 30 minutes by car or courier bike. Click on the photo above to watch a video of the drones in action. (Photo/video copyrights: NHS Guy’s and St Thomas’.)
On-demand Deliveries between Hospital Labs
“Cities like London face a unique challenge. Built vertically but relying on 2D roads, they’re choked by polluting congestion,” commented Alexander Trewby, CEO and co-founder of Apian, in the news release. “Apian’s ambition is to create an autonomous delivery network operating at NHS scale, moving physical items as productively as the internet moves information. If we can pioneer drone delivery here, we can do it anywhere!”
The project is regulated by the UK Civil Aviation Authority (CAA) and initially started in October of last year as a six-month trial, which ended on April 7. The CAA extended the project’s airspace approval for an additional six months. The NHS project now has an expected end date of October 7, 2025.
“Drones can increase the responsiveness and resilience of healthcare logistics, allowing clinicians to be more productive and patients to get the care they need sooner,” Hammad Jeilani, co-founder of Apian, told Healthcare-in-Europe.com. “An NHS drone delivery network in London, starting with this innovative trial, will provide on-demand, automated and sustainable deliveries, helping the NHS create more efficient models of working [with] our doctors and nurses to deliver the highest quality care for patients.”
The drone service runs Monday through Friday during daylight hours and cannot exceed 40 flights per day. During the first six months of operation, there were around 10 flights per day.
Informing Patient Care Quickly
“Tens of thousands of essential patient samples are analyzed by pathology laboratories across London each week,” said Dominic Harrington, PhD, chief scientific officer at Synnovis, in the NHS news release. “Reducing the time it takes to transport these samples means results are available more quickly to inform best possible patient care.”
The Wing drone used for the service is primarily made of foam, weighs about 11 pounds, and can carry packages weighing a little over two pounds. It cruises approximately 62 miles per hour at a height of around 230 feet above the ground.
The use of drones in healthcare is becoming more popular worldwide and the success of such endeavors is evident. In the future, clinical laboratories may depend on drone deliveries to help facilitate optimal results for patients.
Sophie O’Sullivan, director of future of flight at the CAA, told Healthcare-in-Europe.com, “Innovative trials like this from Guy’s and St Thomas’, Apian, and Wing help demonstrate the many positive and safe ways that drones can be used for society—in this case, to improve patient outcomes and deliver significant environmental benefits.”
Though the No Surprises Act was enacted to prevent such surprise billing, key aspects of the legislation are apparently not being enforced
Dani Yuengling thought she had properly prepared herself for the financial impact of a breast biopsy. After all, it’s a simple procedure, especially if done by fine needle aspiration (FNA). Then, the 35-year-old received a bill for $18,000! And that was after insurance and though she had received a much lower advanced quote, according to an NPR/Kaiser Health News (NPR/KHN) bill-of-the-month investigation.
So, what happened? And what can anatomic pathology groups and clinical laboratories do to ensure their patients don’t receive similar surprise bills?
Yuengling had lost her mother to breast cancer in 2017. Then, she found a lump in her own breast. Following a mammogram she decided to move forward with the biopsy. Her doctor referred her to Grand Strand Medical Center in Myrtle Beach, S.C.
But she needed to know how much the procedure would cost. Her health plan had a $6,000 deductible. She worried she might have to pay for the entire amount of a very expensive procedure.
However, the hospital’s online “Patient Payment Estimator” informed her that an uninsured patient typically pays about $1,400 for the procedure. Yuengling was relieved. She assumed that with insurance the amount would be even less, and thankfully, clinical laboratory test results of the biopsy found that she did not have breast cancer.
Then came the sticker shock! The bill broke down like this:
$17,979 was the total for her biopsy and everything that came with it.
Her insurer, Cigna, brought the cost down to the in-network negotiated rate of $8,424.14.
Her insurance then paid $3,254.47.
Yuengling was responsible for $5,169.67 which was the balance of her deductible.
So, why was the amount Yuengling owed higher than the bill would have been if she had been uninsured and paid cash for the procedure?
According to the NPR/KHN investigation, this is not an uncommon occurrence. The investigators reported that nearly 30% of American workers have high deductible health plans (HDHPs) and may face larger expenses than what a hospital’s cash price would have been for uninsured individuals.
Dani Yuengling (above) knew she had to take the lump in her breast seriously. Her mother had died of breast cancer. “It was the hardest experience, seeing her suffer,” Yuengling told NPR/KHN. Fortunately, following a biopsy procedure, clinical laboratory testing showed she was cancer free. But the bill for the procedure was shockingly higher than she’d expected based on the hospital’s patient payment estimator. (Photo copyright: Kaiser Health News.)
Take the Cash Price
In 2021, Bai was part of a John’s Hopkins research team that analyzed US hospital cash prices compared with commercial negotiated rates for specific healthcare services.
“The 70 CMS-specified hospital services represent 74 unique Current Procedural Terminology (CPT) diagnosis related group codes (four services were represented by two codes),” the authors wrote. “Cash prices and payer-specific negotiated prices for the 70 services were obtained from Turquoise Health, a data service company that specializes in collecting pricing information from hospitals.”
They continued, “Cash prices can affect the cost exposure of 26 million uninsured individuals and concern nearly one-third of US workers enrolled in high-deductible health plans, who are often responsible to pay for medical bills without a third-party contribution and thus are interested in having access to low cash prices. In contrast with the commercial price negotiated bilaterally between hospitals and insurers providing insurance plans, the cash price is determined unilaterally by the hospital and might be expected to be higher than negotiated prices.”
However, the team’s research found otherwise. “Across the 70 CMS-specified services … some hospitals set their cash price comparable to or lower than their commercial negotiated price,” they concluded.
Bai advises patients to ask healthcare providers about the cash price before undergoing any procedure no matter what their insurance status is. “It should be a norm,” she told NPR/KHN.
Federal No Surprises Act is not Foolproof
Yuengling was charged an extraordinarily high amount for her procedure compared to other hospitals in her area. Fair Health Consumer estimates the cost of the procedure Yuengling received cost an average of $3,500 at other local hospitals. Uninsured patients likely pay even less.
A spokesperson for Grand Street Medical Center blamed the inaccurate estimate on “a glitch” in the payment estimator system. The hospital has since removed some procedures from the tool until it can be corrected. Yuengling initially disputed the charge with the hospital but in the end decided to pay the full amount she owed.
NPR/KHN recommends that insured patients consult with their health insurance company to get an estimate before any procedure. That is the purpose of the No Surprises Act which was enacted as part of the Consolidated Appropriations Act, 2021 (CAA).
The law requires health insurance companies to provide their members with an estimate of medical costs upon their request. The Act also empowers patients to file federal complaints about their medical bills.
Patients who find themselves in a similar situation to Yuengling may want to consider paying the cash price for the procedure. Although this may not be common practice, Jacqueline Fox, JD, a healthcare attorney and professor of law at the University of South Carolina’s Joseph F. Rice School of Law, told NPR/KHN that there is not a law she is aware of that would prohibit patients from doing so.
Anatomic pathology groups and clinical laboratories should check that their online prices and estimation tools comply with the No Surprises Act to ensure that what happened to Yuengling does not happen with their patients. They also could inform patients on how to pay cash for procedures if insurance rates are too high. Medical professionals and patients can work together to achieve transparency in healthcare pricing.
