New refrigeration technologies like precise temperature performance, continuous monitoring solutions, and data logging capabilities, enable blood banks to deliver blood and its components in their most potent form to patients in need.
Every year, 60 million surgeries from 1200 daily road accidents, 240 million major operations, 331 million cancer-related procedures, and 10 million pregnancy complications are performed in the country, and they often require a serious call for blood transfusion. Blood transfusion saves lives and improves health, but many patients requiring transfusion do not have timely access to safe blood. The need for blood transfusion may arise at any time in both urban and rural areas. The unavailability of blood has led to deaths and many patients suffering from ill-health. A well-organized, well-structured, and effective blood transfusion service is vital for the healthcare delivery system. Unfortunately millions of people are exposed to unsafe blood due to poor storage and inappropriate checking. The blood bank industry plays a life-saving mission, and must keep the blood they collect safe, secure, and viable – and they must do so in accordance with strict regulations. All blood products must be stored under carefully monitored and controlled temperatures and conditions in order to ensure that they are in an optimal state when transfused to patients.
Blood bank refrigerators have evolved to become more than just safe cold storage devices. These refrigeration units come equipped with compressors and insulated cabinets required of any refrigeration device while also providing advanced control over temperature, storage contents, warning alarms, and more. Modern refrigerators are conceptualized and designed to meet the challenging requirement of modern day blood to efficiently conserve whole blood and its derivatives beside a variety of other products such as vaccines, primers, and culture media. The blood bank refrigerators are made of corrosion free metal components with advanced polyurethane insulation ensuring maximum thermal efficiently and durability. The temperature inside the refrigerators is controlled through a programmable, microprocessor-based temperature controller cum indicator. The blood bank refrigerators are provided with a door operated illumination system comprising fluorescent lights.
Another hardware trend used by these blood bank units involves refrigeration with RFID (radio frequency identification) technology. For example, a blood bank storage unit can now be fitted with RFID scanning machines to read blood donor labels and their contents, track on-hand inventory, and track when items have been removed or added. These RFID systems can transmit their data wirelessly to control stations for review and analysis. A network of blood banks can track which of their locations can provide enough blood quickly during an emergency. These blood banks’ smart inventory tracking and storage refrigerators are mostly controlled by industrial-grade hardware and software that have become increasingly more advanced. Moreover advanced medical computer technology has become increasingly available, accessible, and affordable. It can help blood banks maintain a competitive edge while ensuring the integrity of the blood supply.
The global blood bank refrigerators market is expected to show healthy growth in the coming years owing to the rise in number of road accidents and sports injuries. Road accidents and injuries sustained by individuals while playing sports are two of the major factors contributing to the rising number of surgeries that require the use of donor blood to replace the blood loss of patients. Moreover, increasing number of surgery interventions such as cancer, organ and bone marrow transplants, cardiovascular surgeries, general surgery, nephrology, and dialysis results in increasing demand for blood components, thereby driving the growth of this market. For instance, according to the American Cancer Society (ACS), around 1.7 million people were diagnosed with cancer in 2017 and among these, some of the patients need blood daily during their chemotherapy treatment. Lack of timely access to safe blood transfusion will increase demand for efficient, safe, and real-time availability of blood units by blood banks. Therefore, various organizations are getting involved in activities to launch innovative product solutions in the market. For instance, in March 2018, Strides Software Solutions, an India-based firm that enables the availability of safe and high-quality blood components, developed India’s first Aadhaar-based centralized donor authentication and identification application, D-Health app. This app leverages the power of cloud computing to bring all the key stakeholders of blood cycle management including blood banks, donors, blood camp organizers, hospitals, and patients to one platform.
Furthermore, growing demand for blood and blood components will significantly drive the global market. According to the American National Red Cross 2018 data findings, around 7000 units of platelets and 10,000 units of plasma are required daily in the US and around 21 million blood components are transfused each year in the US. The Singapore Red Cross Society needs around 120,000 units of blood every year, to meet the transfusion needs of patients, which is equivalent to over 400 units of blood per day. Furthermore, from the total volume of blood collected by the Singapore Red Cross Society in 2017, blood was mainly used in surgical procedures (54 percent), general medicine (31 percent), hematology and blood diseases (9 percent), and for accident and emergency cases (6 percent). Increasing number of blood donations that will fulfill the rising demand for blood units worldwide is also expected to drive the growth of the market. According to the World Health Organization, 112.5 million blood donations were made globally and an increase of 10.7 million blood donations from unpaid donors was reported from 2008 to 2013.
Vendors in the market are striving hard to garner large shares by offering additional software and hardware products to end-users. B Medical System, software for the collection, long-term data, and visualization of temperature data offers Data Monitoring Network. It offers an integrated event and activity history of all appliance components as well as graphical visualization of all temperature curves. The presence of software and hardware components makes it possible to cater to specific customer requirements and ensure the complete and safe documentation of temperature data, thus leading to increased adoption of blood bank refrigerators. Numerous community and neighborhood dealers are placing forth unique application objects for differed end-clients. The new vendor contestants are facing tough competition to cope with the regular merchants in terms of value, dependability, and tendencies in innovation. Some of the key players operating in the global market include Becton, Dickinson and Company; Thermo Fisher Scientific; Abbott Laboratories; Fresenius Kabi; Beckman Coulter; bioMérieux; China Biologic Products Holdings; Immucor; Instrumentation Laboratory; F. Hoffmann-La Roche; Haier Bio-Medical; and Remi Group.
The most common problem in the blood bank refrigerators is the temperature-alarm system and the monitoring of refrigerator temperature.
Temperature monitoring. The global standard for blood bank and transfusion services necessitates that refrigerators, freezers, and platelet incubators have a system to monitor temperature continuously and must record the temperature at least every four hours. The temperature should be displayed digitally and previous recording readily made available to easily see trends. On power failure, the system should ensure no compromise of monitoring for a period of time, specified by the manufacturer. Moreover, data backup must ensure that in the event of hardware failure, the system integrity and temperature data integrity are not compromised.
Alarm system. The standard for blood bank and transfusion services requires that the alarms be presented on refrigerators, freezers, and platelets incubators and activate at a temperature that allows taking proper action before stored blood or components reach exceeded temperature levels. An audible alarm equipped on refrigerators or freezers must be activated within seconds of temperature shifts or critical power failures. An alarm should be audible and cover maximum personnel coverage area so that immediate proper action can be taken. The alarm systems are mandatory to monitor temperature as well as critical power failures and inform unsafe temperature in order to rectify the situation and move units in a timely manner.
Blood banks, crucial in bringing life-saving benefits of transfusion to patients in need, are of key importance in medical logistics, ensuring the availability of safe and effective blood components in a timely manner. The easiest way to accomplish this is to have an appropriate inventory of products of optimal quality on the shelf at all times, and highly specialized refrigeration equipment is critical to achieve this. Because the required storage temperatures of blood products need to be maintained 24×7 and can be subjected to different variables (frequency of door openings, product load density, power outages, and changes in room temperature), the accuracy of the temperature control systems used in blood bank refrigerators and plasma freezers is crucial.
Microprocessor-based control is the most advanced, precise, and reliable technology for controlling and maintaining temperatures. The onboard monitor makes provisions for alarm conditions through both audio and visual indicators, tracking events such as open doors, temperature deviations, and power failures. Battery backup capabilities are also essential to ensure full alarm functionality in the event of a power failure. The recent integration of dual cooling technology differs significantly from conventional cascade refrigeration technology in fundamental design and operation. In dual cooling systems, the two independent refrigeration systems provide a reliable and exceptionally stable ultra-low temperature environment. In case of an unexpected failure of one cooling circuit, the other circuit will maintain the freezer in the preferred range, protecting samples until service can be arranged. This level of ultra-low temperature back-up cannot be achieved by conventional cascade systems.
As technology has evolved, so has the way users can monitor and interact with their precious cargo. High-performance blood bank refrigerators and plasma freezers are now compatible with external, wireless monitoring solutions. New systems are designed to monitor critical parameters, including temperature, relative humidity, CO2 concentration, and differential pressure. In the event of a power or mechanical failure, the wireless monitoring device instantaneously notifies users through audio/visual alarms, email, text message, telephone, and fax. All of the data that is being monitored is continuously recorded to meet various regulatory requirements.
New units are also available with embedded motherboards. Once integrated into a blood inventory and storage unit, the embedded motherboard performs the job of controlling, monitoring, comparing trends, and reporting temperatures to ensure smooth and reliable operation. These embedded motherboards can process large amounts of data, both rapidly and accurately. They can wirelessly transmit key data via their wi-fi or ethernet features to provide control centers with crucial operational information, that is, real-time temperature monitoring, detailed supply of blood, alerts for any issues that may arise, reordering timing, and additional requirements. Some of these blood bank refrigeration units include user-friendly graphical displays, icons, and alarms to visually and audibly communicate the system’s status. For example, a green thermometer icon communicates that conditions are normal whereas a red flashing one would indicate that the temperature is too high. Audible and remote alarms are also available, enabling blood bank workers to promptly respond when a warning is triggered.
Internet of things
Healthcare as a sector is a definite candidate for increasing adoption of technologies related to IoT. One such area is blood bank management. Thousands of liters of blood get wasted every day across the country and this wastage is occurring during a day and age when healthcare providers are battling acute shortage of blood units for various medical procedures. Given this backdrop, the significance of deploying technologies that encourage efficient management of blood banks cannot be understated. Through IoT, blood banks can gain two advantages. On the one hand they get access to data that can be put to various end uses while on the other, blood units can be monitored in real-time to ensure that there is no spoilage or wastage due to temperature fluctuations or pilferage. This also removes any scope for tampering at the storage level. Sensors embedded in refrigerators and other storage/handling devices can offer real time information on the status of blood (temperature, quantity, and storage information).
A gap analysis in hospitals invariably leads to the discovery of lack of real-time monitoring and measuring equipment as a significant weakness. A data gathering strategy that works on monitoring the blood bank on a 24×7 basis through IoT-driven automation, frees employees from the onerous task of having to monitor refrigerators and storage equipment continuously and maintaining records that involve cumbersome paperwork. The National Health Policy 2017 raises concerns about access to blood and blood safety. Lack of linkage between peripheral health facilities and central level blood banks is also one of the reasons for blood wastage. Many of the blood units are destroyed by blood banks after their expiry date. This blood could have been given to the needy patients before its expiry through linking of district blood banks with peripheral health institutions. IoT can help on both these counts. With blood availability data automated, each blood bank can publish such information online for stakeholders. Banks can also be networked so that requests are automatically forwarded to the nearest bank in case of a shortage.
Keeping this in mind, the health ministry also launched the e-RaktKosh initiative, an integrated blood bank management information system (MIS) that interconnects all the blood banks of the state into a single network. This web-based mechanism is also able to assemble heterogeneous data into legible reports to support decision making from effective donor screening to optimal blood dissemination in the field. The integrated blood bank MIS refers to the acquisition, validation, storage, and circulation of various live data and information electronically regarding blood donation and transfusion service.
The availability of safe blood and blood products is essential for diverse modern healthcare services. Choosing high-performance products, like the technology currently available in cold storage equipment, is a critical step in maintaining blood supply. New refrigeration technology incorporates features like precise temperature performance, continuous monitoring solutions, and data logging capabilities that are critical for blood banks to deliver blood products in their most potent form to patients in need. The Indian blood transfusion industry is considered an area which requires legal regulations as the industry is not only fragmented or decentralized, but equally diversified in ownership pattern. Yet we do not have a well-defined and stringent regulatory framework for blood products regulation. Frailty may arise from the inability of the government to enforce laws, regulations, and policies and personnel who may not be aware or cannot follow quality assurance and/or good manufacturing practices. While the health sector in the country has made outstanding accomplishments in the past few decades, there are several areas that need to be addressed as it potentially affects the timely availability of safe blood products, which calls for strengthening the planning and monitoring of blood transfusion services.
India has approximately 2903 blood banks spread all across the country, of which 1043 are public and 1860 private, including those run by charitable trusts. Maharashtra leads with 328, followed by Uttar Pradesh (294) and Tamil Nadu (291). On the other hand, 74 districts across 17 states do not have a single blood bank. Assam has 12 such districts, followed by Arunachal Pradesh and Telangana, each with 10. Chandigarh, which reported the highest blood collection as per requirement in 2017, has only four blood banks. On the other hand, Uttar Pradesh, with the second highest number of blood banks in the country, was 61 percent short of its requirements. In addition, there are more than 6000 facilities such as district hospitals (DH), sub-divisional hospitals (SDH), and community health centers (CHC) present across India excluding medical colleges, and more than 80 percent of these lack blood bank refrigerators/freezers to properly store blood. The National Blood Policy of India acknowledges this grave situation and the government has proposed an increase in blood storage facility by setting up blood banks in 68 districts of the country to provide services in the rural hinterland. Accordingly each district in the country is expected to have at least one blood bank in years to come. This trend along with the focus on prevention of blood wastage will certainly lead to increased demand for blood refrigeration units for proper storage.