AABB News: The Evolution of Technology and Its Impact on Blood Donations

This article originally appeared in AABB News, a benefit of AABB membership. Join AABB today to read the rest of this month’s issue.

In 2016, the United Kingdom’s National Health Service’s Blood and Transplant (NHSBT) launched an award-winning digital outdoor advertising campaign to highlight the life-saving power of blood donation and enable the public to give a virtual blood donation via a smartphone. The Power of Blood campaign, which featured empty blood bags and real-life recipients on digital billboards, used innovative augmented reality technology to simulate the blood donation process. Virtual donors in busy shopping areas witnessed the benefits of blood donation firsthand as blood transferred from their screen to ill patients shown on the billboard in front of them, restoring them to health. The successful digital campaign motivated spectators to become real-life blood donors, demonstrating the power of technology and its ability to empower people to act and increase blood donation.1

“We are always looking at new and creative ways to demonstrate the life-saving importance of blood donation. We know that often people may not have thought about it or found the time to sign up. By utilizing the latest technologies and working with partners – like Ocean Outdoor and Westfield who provided us with this particular opportunity – we were able to reach and inspire people who may not have otherwise thought about becoming blood donors," stated Nadine Eaton, head of campaigns for blood donation at NHS Blood and Transplant. “We continue to explore new ways and opportunities to keep new donors coming forward! Each donation can save or improve up to three lives.”

The evolution of technology has drastically changed blood donor recruitment strategies and campaigns throughout the past 20 years. Gone are the days when blood centers solely relied on direct mail, on-site events and cold-calling landlines to recruit blood donors and raise awareness about the importance of donating blood to save lives. In today’s digital age, donor recruitment professionals can communicate, inform and engage with potential and current donors through modern technologies, including mobile apps, social media and virtual experiences. From mixed reality technology to podcasts and game apps, the following AABB institutional members share how novel innovations and emerging technologies in the blood banking field have shaped their donor recruitment efforts and helped them address donation challenges.

NOVEL INNOVATION: Mixed Reality

SOLUTION: Attracting younger generations

Nearly 5 million people in the United States need blood transfusions each year.2 The majority of blood donations come from people aged 40 years or older. As repeat donors age out of the donor pool, young donors are essential to sustaining a reliable blood supply. However, only 10% of donations come from people aged 23-29 years, and 12% from people in their 30s.3

“We’ve seen a 30% decline in donors under the age of 30 throughout the past decade, with the biggest donor decline being millennials between 2020-2021,” said Harpreet K. Sandhu, CEO of Stanford Blood Center, and Blood Centers of America (BCA) chair. “Someone in the U.S needs blood every two seconds, but only about 3% of the nation’s population donates. The significant loss of younger donors is a critical issue for our nation’s blood supply.”

To enhance the blood donation process and motivate younger donors to give blood, Abbott and BCA launched an immersive, mixed-reality experience that merges the real world and digital elements. In virtual reality, users can only experience the digital world, but mixed reality technology allows users to see and hear the real world around them as they immerse themselves in a virtual environment. “We knew we had to do something as an industry to essentially stabilize the nation’s blood supply over time and grow the younger generation of blood donors, not only as first-time donors but repeat donors,” Sandhu told AABB News. “We wanted to develop an innovative solution that spoke to the next generation of donors.”

While giving blood at a participating blood center, donors wear a lightweight mixed reality headset to enter the digital world where they visit a whimsical garden with soothing music and plant seeds that bloom into colorful trees and flowers. The program uses Microsoft HoloLens 2, a self-contained holographic computer that enables hands-free interaction with three-dimensional digital objects. The technology is one of the first-ever, consumer-focused mixed reality applications controlled entirely through eye tracking, allowing blood donation professionals to safely conduct the donation and interact with donors and assess them at every step of the process. Donors’ eyes are always visible throughout the donation process, and their arms remain stationary, which is important for donors’ safety, she noted.

“This is the first time this type of technology has been introduced to blood donations,” Sandhu said. “Not only is it an opportunity to implement this innovative technology and mixed reality into the blood donation process, but this experience is very exclusive to blood donors. The digital experience was specifically created by understanding the blood donation process, as well as the donors and the feeling we want them to have.”

The technology was piloted at select BCA locations. An onsite study conducted at New York Blood Center in Brooklyn last December indicated positive feedback. Participants reported the digital experience enhanced their blood donation process—90% said they had a positive experience, and 94% said they are likely to donate again using mixed reality. Incorporating technology into the donation process adds a creative and interactive element that may entice this key demographic and existing donors to come back more often, Sandhu pointed out.

“Most of the younger generation has an aspect of technology in every phase of their life from ordering food to watching television, so we wanted to focus on an innovative opportunity to technologically enhance their donation experience and engage them in a creative way while they are giving blood,” Sandhu said. “Offering a more relaxing and intriguing donation experience allows us to have another element of distraction for the donor and potentially reduces their anxiety about donating.”

The mixed-reality opportunity, she stated, is a result of a partnership among BCA, Abbott and blood centers that participated in the pilot study, which includes Gulf Coast Regional Blood Center and ImpactLife. Sandhu anticipates that Abbott, an AABB CORD-level donor, will roll out the mixed-reality technology at additional BCA blood centers later this year. “Blood centers play an important role and have a lot of responsibility, but ensuring a sustainable blood supply and having robust transfusion medicine programs nationwide is a collaborative and industry effort,” said Sandhu. She noted that Standard Blood Center was instrumental in the pilot study design.

“Everyone came together to figure out how to make this a reality and structure the pilot study to make this an effective tool. Every patient who needs a blood transfusion can access one through our collaborative efforts. As an industry, we are really in this together.” 

 

NOVEL INNOVATION: Podcast

SOLUTION: Teach, Reach, Inspire

Podcasting has gained steady traction in popularity since the introduction of the first podcast in 2004. More than 82 million people listened to podcasts in 2021, and this number is estimated to rise to 100 million listeners in 2024.4 To date, there are more than 2.5 million podcasts listed in Apple podcasts with health featured as a top-level category.5 Despite the saturated market, Susan Forbes, senior vice president of corporate communications and public relations at OneBlood, discovered that launching a podcast on blood banking and donation had untapped potential.

“Podcasts are extraordinarily popular, but there aren’t many podcasts solely dedicated to blood donation,” Forbes told AABB News. “We discovered that our podcast is another avenue to reach people. It’s important that we are on every platform that’s available these days so that people can learn more about blood donation and hopefully get inspired to donate. We also want to market to people who aren’t donating. Hopefully it will help them see they are needed.”

Launched in 2021, the Share Your Power podcast produces informational and inspirational stories to raise awareness about the importance of donating blood and the massive efforts taking place at OneBlood and around the world to save lives. The podcast takes listeners behind the scenes, providing insight into the blood donation process and how donors play a role in saving lives. To date, podcast episodes have covered the diversity of the blood supply, rare blood types and the Pulse Nightclub mass shooting, which features emotional interviews from survivors and blood donors.

“There are so many amazing stories about people’s lives being saved. Sharing those stories educates the public about the importance of a ready blood supply and the powerful impact of their donations,” Forbes said. “There’s so much that happens in blood centers that most people don’t know about. I’m happy that our audience finds these topics interesting. Our mission is to educate, inform and inspire. It’s all about catering your message to your audiences so that they can learn more about your mission.”

Share Your Story debuted its first video podcast on YouTube to discuss O-negative blood donors and their unique ability to save the lives of premature babies. Forbes said she hopes each episode sparks insightful conversation and inspires current donors and potential donors to take action.

“We want our podcast to capture people, whether they can hear it or see it,” she said. “Unfortunately, the blood supply is all too often taken for granted. Our podcast has really helped people understand that it is a massive effort to save people’s lives, and we cannot do it without the donor. It’s all about bringing it back to blood donation, and the power people have to save another person’s life.” 

 

NOVEL INNOVATION: Artificial Intelligence (AI) Algorithm

SOLUTION: Reduce needle phobia

Research shows the fear of needles affects up to 25% of adults.6 People with needle phobia may avoid donating blood due to the increased risk of vasovagal reactions (VVRs), including nausea, dizziness, vomiting or fainting.

To help people overcome the common blood donation fear, Elisabeth Huis in ‘t Veld, PhD, assistant professor at the department of cognitive science and artificial intelligence at Tilburg University in Tilburg, Netherlands, and PI donor cognition at the department of donor medicine research at Sanquin, Amsterdam, developed a game app that can measure and predict whether a person is on the verge of fainting based on thermal face images. Huis in ‘t Veld spoke with AABB News about her team’s research and the inspiration behind creating the app.

“We know that the fear of needles and fainting is a major barrier for blood donations. If we can help people get over their fear, it might convince more people to donate,” Huis in ‘t Veld said. “The idea is for people to play the game we developed in the waiting room prior to their blood donation to help lower the risk of VVR reactions. It helps them gain control over negative emotions and physical symptoms in their body, so they don’t faint.”

In 2022, principal investigator Huis in ‘t Veld and her coinvestigators published a study in Transfusion that examined whether fluctuations in facial temperature in several facial regions are related to the level of risk for vasovagal reactions in a simulated blood donation. They recruited students at Tilburg University and filmed them throughout a virtual blood donation using an infrared thermal imaging (ITI) camera and a regular camera. Then, they completed ITI data pre-processing on each video frame by detecting facial landmarks and image alignment before extracting the mean temperature from six regions of interest. Their findings showed a significant correlation between self-reported vasovagal reactions and temperature fluctuations in the area below the nose.7

Their study is the first to demonstrate it may be possible to predict whether a person will suffer from adverse emotional or physical reactions prior to donation, based on their facial reactions in the waiting room, Huis in ‘t Veld explained.

“We noticed donors fainting before they had blood drawn, and their heart rate increased before the needle insertion,” she recalled. “We found that we can accurately predict who will experience VVR by viewing regular video images of donors in the waiting room.”

Huis in ‘t Veld and her team used the data to develop AI algorithms that measure early signs of fear or fainting in the user’s face and predict how they are doing. The AINAR (Artificial Intelligence for Needle Anxiety Reduction) app uses automatic recognition of facial patterns in an artificial intelligence-driven biofeedback game that will help donors and patients conquer their fear of needles in an independent way, prior to donation, she explained.

How it works: The algorithm uses the front-facing (selfie) camera on smartphones to detect early signs of VVR reactions, and it controls the weather in the game based on the user’s well-being. For example, if the algorithm registers any signs of anxiety or fainting, it will rain or snow. Once the user relaxes and calms down, the sun will shine again. The game will let users know how they are doing before they know it themselves, she pointed out.

“Our algorithm lets us see if things are going in the wrong direction, so we can intervene at a very early stage. The weather is a direct reflection of how users are doing, so they have to find out what works for them to get it under control,” Huis in ‘t Veld said.

The game, she added, can help people get their power back.

“We want to communicate that with donors because people feel like they cannot control themselves regarding VVR reactions. They feel embarrassed and ashamed, so we want to give them the tools to feel in control and powerful again when they are donating blood,” Huis in ‘t Veld told AABB News. “If we can help people prevent an adverse reaction, then donors are more likely to return. Needle fear exists, and we hope that the game we developed can benefit blood centers throughout the world.”

REFERENCES

1. NHS uses VR technology to attract New Blood Donors. NHS Blood Donation. https://www.blood.co.uk/news-and-campaigns/newsand-statements/nhs-uses-vr-technology-to-attract-new-blooddonors/

2. U.S. Blood Supply Facts. Facts About Blood Supply In The U.S. | Red Cross Blood Services. (n.d.). https://www.redcrossblood.org/ donate-blood/how-to-donate/how-blood-donations-help/bloodneeds-blood-supply.html

3. Millennials & Gen Z: If you’re reading this, give blood. Abbott. (n.d.). https://www.abbott.com/corpnewsroom/diagnostics-testing/ millennials-gen-z-if-you-reading-this-give-blood.html

4. Götting, MC. (n.d.). Topic: Podcasting industry. Statista. https:// www.statista.com/topics/3170/podcasting/#topicOverview

5. Apple podcasts statistics. Podcast Industry Insights. February 23, 2023. https://podcastindustryinsights.com/apple-podcastsstatistics/

6. Centers for Disease Control and Prevention. March 8, 2023. Needle fears and phobia – find ways to manage. Centers for Disease Control and Prevention. https://www.cdc.gov/ childrensmentalhealth/features/needle-fears-and-phobia. html#:~:text=Estimates%20show%20that%20as%20 many,have%20strong%20fears%20around%20needles.

7. Rudokaite, J, Lee-Ling SO, Huis in‘ t Veld, E, et al. Predicting vasovagal reactions to a virtual ... - Wiley online library. February 21, 2022. https://onlinelibrary.wiley.com/doi/10.1111/trf.16832