Dr. Karen Roush enjoys the little details of science that, she admits, can make some people’s eyes glaze over – a convenient coincidence for the person responsible for analyzing complex blood transfusion issues down to the molecular level.
Dr. Roush is intimately involved with all aspects of transfusion medicine services at Methodist Dallas, and for all the Methodist Health System facilities. She works behind the scenes to keep things running seamlessly. Roush shares that her pathology department sees a number of patients with complex transfusion requirements – people with both acute and chronic issues. She says the recent availability of molecular phenotyping affects the delivery of care to those patients.
“Molecular phenotyping is something that is relatively new to transfusion medicine in terms of its availability to many hospitals,” says Dr. Roush, vice chairman, department of pathology for Methodist Health System. “I think it provides some important benefits to our patients who have sickle cell disease; autoimmune hemolytic anemia; hemolytic disease of the newborn or those who are at risk for having hemolytic disease of the newborn.”
Previously, the only way experts in transfusion medicine were able to determine the best blood match between a donor sample and a patient’s red cells was to use antibodies that were provided from other donors, which are in short supply; especially, for assessing rare blood types. Molecular methods allow specialists to characterize a patient’s blood type, regardless of whether or not the patient has their own cells or someone else’s already transfused cells.
“It [molecular testing] should decrease the costs and the turnaround time of availability for transfusion for many of our critically ill patients.” – Dr. Roush
“This method, primarily for future transfusions, enables us to provide patients with the best matched blood product,” says Dr. Roush. “It’s also allowed us to tease out some very difficult situations in which patients have autoimmune diseases. So, I think this is a very important methodology that can be utilized to benefit patients in a variety of ways. Especially, very complex patients who may have several medical issues going on, not the least of them being their red cell transfusion difficulties.”
Dr. Roush admits there is concern within the blood bank community, as well as with many executives responsible with hospital budget oversight, that molecular testing is going to increase transfusion costs. However, she points out there’s a one-time, per-patient cost associated with performing red cell phenotyping.
“I think ultimately, that while this may be an increased cost on the front end of what we’re doing, it should decrease the costs and the turnaround time of availability for transfusion for many of our critically ill patients,” says Dr. Roush. “So, I’m looking forward to a wider availability of those types of tests for our patients.”
Carter BloodCare, with its recent AABB accreditation, is performing limited molecular testing for Methodist under the blood center’s current protocols – including testing of patients with rare blood types.
“Transfusion medicine has been a little slower, I think, in their acceptance of molecular methods, but it seems to be just on the cutting edge of an explosion in the near future. So, I really think that it will become the standard of care in a very short time.”
“I don’t think you can underestimate the goodwill that’s engendered by a blood center that’s within your community that the community recognizes and knows.”
Quality and Expertise – Selecting a Blood Center
Dr. Roush also serves on a team of medical and laboratory professionals who routinely assess current and prospective centers providing blood services to the Methodist Health System. She shares the most common factors in their decision are:
- Community involvement
- Quality and availability of blood products
- Reliability of customer service
- Expertise and availability of medical directors
- Turnaround time
- Pricing of products and services
“Nationally, I think blood centers provide a wide scope of drawing products from different areas, and are extremely helpful in times of different crises,” says Dr. Roush. “But, I don’t think you can underestimate the goodwill that’s engendered by a blood center that’s within your community that the community recognizes and knows. And, is willing to participate actively in the donation that is so important to our patients here in the area in which they serve,” says Dr. Roush.
Dr. Roush is the Vice Chairman of the Department of Pathology at Methodist Health System.