May 13, 2022

8 Things You Need to Know About Dried Blood Spot Testing

Ash Team

As the solution of choice for remote diagnostics, Ash Wellness offers dried blood spot (DBS) card testing to our partners in student health, major healthcare systems, primary and specialty care, and consumer wellness companies. We provide infrastructure to seamlessly switch on at-home diagnostic testing, and deliver quality white-labeled test kits to customers and patients, including premium devices to collect urine, serum, stool, saliva, and blood. DBS card tests allow patients and users to submit samples to labs with only a small amount of blood rather than undergo a more invasive at-home phlebotomy procedure. In this article, we will discuss the advantages of DBS cards, and how Ash Wellness current and potential partners can utilize this type of popular home health testing.  

An example of what a dried blood spot (DBS) card looks like.

1. How do DBS cards work?

If you’re not a doctor or a lab technician, this part may be a little too scientific for your needs — but read on if you’d like to know the details. DBS cards use filter paper to absorb blood samples. Users prick blood from a fingertip, and blot it onto the card. Each card contains five 13 millimeters circles, and each circle holds about 75-80 microliters of blood. The blood sample dries in a fibrous matrix, and is shipped to the telemedicine lab — one of our certified CLA/CLIQ partners – for review. At the lab, technicians punch the five spots out. The spots are then eluted into a liquid solvent to extract the target analytes from the paper. Technicians analyze samples against markers to determine results. 

2. What types of at-home health tests can DBS cards run?

Home diagnostics through DBS cards can be used to screen for infectious diseases, fertility markers, allergies, cancers, comprehensive metabolic panels, and more. Currently, Ash Wellness can run every single test validated for DBS cards. (Chat with us for a complete list of DBS card test options.)  We operate in all 50 states, and use microtainers to collect serum specimens in New York State due to state regulations. In this case, the blood travels closer to whole blood as opposed to dried-out. 

3. Which Ash Wellness partners use DBS cards?  

We are thrilled to provide collection devices, operations management, and technical support, and more to support DBS card collection and additional home blood collection methods. See some of our featured home health testing partners below: 

Some Ash Wellness partners who use DBS cards for at-home testing.

4. How can businesses use DBS cards for home diagnostics? 

Our PrEP partner uses DBS cards to conduct quarterly HIV testing from PrEP users across all 50 states. This business ships 10,000 kits a month to onboard and monitor customers on PrEP. Without DBS card at-home diagnostic tests, these customers would have to visit labs every three months to get blood drawn. Only two in five people keep taking PrEP for two years after starting, and according to a public health investigation published on the JAMA Network, “individuals with lower socioeconomic status, and individuals with a substance use disorder were more likely to experience gaps in the PrEP continuum of care.” Home diagnostics can help close some of those major care gaps, and allow businesses to reach and maintain customers for the long haul.  

5. How does DBS testing break down barriers to care, and why should businesses offer them?

At-home diagnostic testing broadens popular telehealth options, makes healthcare more accessible to vulnerable communities, helps reduce the racial care gap, expands HIV care, and more. DBS cards tests are an easy point of intervention for people who might not already interact with healthcare. Through home diagnostics like DBS cards, your business can offer tests — HIV, cancer, etc. — normally limited to in-person laboratory testing. Healthcare businesses (hospitals, clinics, university healthcare systems, etc.) and consumer companies can create a complete telehealth care cycle for patients and customers. 

DBS card testing is also particularly useful for public health initiatives. Street teams responsible for collecting blood samples normally have to worry about transporting blood at temperature with a stabilizer. Our cards can literally be stored and sent in envelopes. DBS home health testing allows teams to collect and store a greater number of specimens without the samples going bad. 

6. What does the DBS card process look like? 

Most everyday people aren’t familiar with the DBS self-testing process, which is why we’ve created awesome video tutorials and digital instructions for providers and partners to share with patients and customers. We show users how to collect blood correctly for an overall positive self-testing experience through telemedicine services.

Using a DBS card for at-home testing is easy.
  1. The user pricks his/her/their finger. This person applies capillary blood to a filter paper, which dries the blood in a fibrous matrix. 
  2. When the lab receives the sample, technicians “punch” out blood spots from the paper.
  3. These punched blood spots are eluted into a liquid solvent to extract the target analytes from the paper; this is done via immersion on a shaker (4 - 12 hours) and centrifugation (several minutes). 
  4. Samples are analyzed against markers to determine results.

7. Is DBS at-home health testing accurate? 

Yes! While DBS card testing is slightly less sensitive for certain markers due to reduced sample quantity, peer-reviewed studies report that it can pick up diseases like HIV, Hep B and C, or COVID antibodies. Schedule a time to chat to receive detailed documentation on DBS cards, and learn more about DBS card accuracy. 

8. How are DBS tests different from at-home phlebotomy? 

DBS tests require a small amount of blood from a pricked finger tip, which the user then presses onto a dried blood spot sample card. DBS cards are easy to self-collect, store, and transport. DBS is not approved for all tests, and the elution step — wherein the blood is extracted from the card — adds an additional four hour wait time. However, DBS card self-testing breaks down barriers to care for patients, who can take the tests in the comfort of their homes. This allows hospitals and clinics to reach patients they might not normally have access to, and helps consumer companies to scale quickly without hiring skilled technicians. Providers can order DBS card tests to patients via a regular drop-down option in their EMR system. At Ash Wellness, our lab testing API is set up to transfer data smoothly between the lab and EMR. 

Phlebotomy, which relies on intravenous extraction, requires skilled staff and special equipment, but is more widely accepted. A phlebotomist or lab technician punctures a vein and draws enough blood to multiple tests. However, phlebotomy is expensive and doesn’t necessarily break down barriers to care. The blood needs to be transported with a stabilizer within temperature range, which can increase cost. 

Learn more about how DBS card testing can impact your business or healthcare organization. Schedule a time to chat here.

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