BANGOR, Maine — Eastern Maine Medical Center expects to save about $175,000 per year by stepping away from American Red Cross Blood Services for the first time in decades and starting a new relationship with a smaller West Coast blood provider, according to the doctor who oversees EMMC’s blood management operations.
The Bangor hospital announced Monday that it will sever its longstanding business ties with the Red Cross blood distribution wing, instead buying blood and blood products from Seattle-based Puget Sound Blood Center. EMMC had been purchasing blood from the Red Cross since the organization began providing blood in Maine probably 30 to 40 years ago, according to Dr. Irwin Gross, medical director for the hospital’s Patient Blood Management Program. Prior to that, EMMC handled its own donations in-house.
Eastern Maine Healthcare System’s other hospitals, including Blue Hill Memorial Hospital, Mercy Hospital in Portland and others, also will benefit from the reduced blood prices, potentially bringing the total savings for the health care system to more than $200,000, according to Gross. EMMC officials did not provide the dollar amounts of the contracts with Puget Sound or the Red Cross requested by the BDN.
Along with the savings, Gross said blood from Puget Sound will be “fresher.” Puget guaranteed that the blood would reach the hospital within seven days of its donation, a pledge that the Red Cross couldn’t match because of its obligation to supply many other hospitals in the region, according to Gross.
According to Gross, scientific literature suggests that the shorter time blood is “stored,” the better the results of the transfusion and the better off the patient.
Gross stressed that the blood from Puget Sound is held to the same safety and quality standards as the blood from the Red Cross. The U.S. Food and Drug Administration regulates the collection of blood and blood components used for transfusion for every group that distributes blood in the country, including Puget and the Red Cross. All distributors are required to follow the same rules — ranging from restrictions on who can donate blood to the lengthy list of diseases that blood must be tested for before it goes into someone else.
EMMC needs considerably less blood than it used to. According to the hospital, the number of units used in red cell transfusions dropped from more than 8,000 in 2006 to fewer than 4,000 by 2009. The number of units of plasma and platelets transfused, though smaller, show similar trends and also fell dramatically since 2006.
That has a lot to do with the hospital ramping up its efforts to prepare patients — and their blood — for surgery, according to Gross. EMMC has been using a three-pronged approach to “patient blood management.” First, doctors try to optimize the patient’s own red blood cells, treating anemia early on to ensure red blood cell counts are high. Second, surgeons and doctors work to limit the amount of blood lost in the hospital through minimally invasive surgeries, medications and other means. Third, doctors are recognizing that patients tolerate anemia better than once believed, and now know they can allow blood counts to fall lower than what would have been considered safe in the past.
“We’re approaching [patient] care in a new way that avoids transfusion and actually improves their outcome,” Gross said.
Gross also said that EMMC and Puget would be “partners in furthering the strategies that we apply in terms of patient blood management,” to continue the trend of decreasing use of transfusions. Red Cross doesn’t provide those sorts of services in Maine, he said.
“We’ve had an ongoing discussion with the Red Cross about these issues for a number of contract cycles,” Gross said.
Maureen Malone Wellman, communications manager for American Red Cross Blood Services based in West Henrietta, N.Y., declined to answer most questions about the financial impact of EMMC’s announcement, citing “proprietary information,” but did reiterate that the American Red Cross “regrets” EMMC’s decision to contract with another provider.
Wellman did talk about what happens to blood after it is donated. When someone donates blood to the Red Cross in Bangor or at a blood drive in Fort Kent or anywhere else in Maine, that blood is taken to a lab in Dedham, Mass., to be processed into components — red cells, platelets and plasma. At the same time, test tubes are sent to a National Testing Lab in Philadelphia, where more than 12 tests are conducted on each product to test for infectious diseases. After that, the blood is labeled and distributed to hospitals throughout the region. That typically all happens “within a few days,” according to Wellman.
Puget has a similar process, but it’s localized to the Northwest, and the blood is sent out to 77 hospitals, including a few in New York and New Jersey. Transporting blood over long distances has become a far more efficient process over the years, according to Gross.
The maximum amount of time the FDA allows blood to be stored is six weeks.
The Red Cross handles about 40 percent of the nation’s blood supply. Most blood is used regionally, but it sometimes is shipped to other regions when they encounter shortages of a certain blood type. Maine is an exporter of blood, donating far more than is used in its hospitals, according to Gross.
Wellman said that the loss of the EMMC contract will not affect the Pine Tree Chapter of the Red Cross or the services it provides. It continues to supply blood to other Maine hospitals, including St. Joseph Hospital in Bangor.
The shift “in no way means that we aren’t going to support the Red Cross,” Gross said, adding that the hospital will continue to support Red Cross blood drives.
Jeff Austin, vice president of government relations for the Maine Hospital Association, said Tuesday that he wasn’t surprised to hear about EMMC’s decision to switch blood providers as a cost-saving measure.
Hospitals across the country are digging into their budget line items, looking for ways to save money and survive, according to Austin.
“Hospitals are under a lot of financial stress right now,” he said, citing decreases in state and federal funding, a soft economy, high levels of uninsured patients and increases in high-deductible patients who can’t afford to pay their hospital bill.
He said patients shouldn’t worry about the quality of the blood changing under Puget, because they’re held to the same standards as the Red Cross.
“They’re not going to sacrifice quality to save a buck,” Austin said. “The care delivered to patients is too important.”