Theranos: Saving Lives Drop by Drop

by Joy Cui

Phlebotomy—the act of puncturing a vein to draw blood. Thousands of Americans undergo this minor procedure every day in hospitals, doctor’s offices and health facilities. Despite the simplicity of the procedure, the power of a blood test cannot be overlooked. It is one of the most common methods used to measure levels of compounds and proteins—immune cells, red blood cells, cholesterol, antibodies and insulin—circulating through the body. Blood test results help health professionals detect disease and infection, diagnose patients and determine proper treatment.

While the majority of Americans are familiar with the quick “pinch” of a needle at the crest of a forearm, many are unaware that the blood-testing field is undergoing a revolution. Theranos, a molecular diagnostic company founded and run by Stanford University-dropout Elizabeth Holmes, recently patented technology that will make laboratory tests cheaper and faster than traditional blood tests and will require one-thousandth of a sample size than a typical blood draw.

According to Holmes, between “forty percent to sixty percent of people, when they’re given a requisition by a doctor to get tested, don’t, because they’re scared of needles or the locations are inconvenient or the cost is too high.” Motivated by her own fear of needles and blood, Holmes developed a way to carry out up to thirty different blood tests from only 25 to 50 microliters of blood. This amount is equivalent to a raindrop! In comparison, traditional methods require 3000 to 5000 microliters of blood.

The first step of a Theranos test is a quick finger prick, which is designed to minimize pain and discomfort. Samples are collected on a disposable cartridge in Theranos’s nanotainer, a tube that stands 0.508 inches tall—smaller than a dime. The cartridges are then inserted into readers of special analytical systems created and used exclusively by Theranos. The readers are able to analyze the blood sample by conducting cell counts, checking for the presence of certain molecules and detecting levels of hormones, compounds and proteins. Next, the results are electronically sent back to medical professionals and released to patients within just four hours of the blood draw. This is a remarkably short turnover considering the days to weeks Americans currently wait to receive test results.

To increase accuracy and eliminate delays between retrieving blood and sending out results, Theranos conducts all of its work—from the finger prick to the analysis of the cartridge—in its two facilities in Phoenix, Arizona and Palo Alto, California. By doing everything on site, samples don’t have to be transported between hospitals or medical offices and laboratories, saving both sides a significant amount of money in the long run.

Holmes also employs this model because it reduces human handling of bodily liquids, which, according to the ECRI Institute—a nonprofit group formerly known as the Emergency Care Research Institute dedicated to improving patient care—is the cause of seventy percent of test errors. Since Theranos’s cartridge removes the need to pipet samples into machines or centrifuge samples, there is also a decreased chance for contamination.

Unlike traditional methods, which may involve multiple facilities handling blood with different equipment manufactured by numerous vendors, Theranos ensures that the same calibrated equipment is used. To further save time and decrease delays between tests, the test can be immediately redone on the same sample of blood. The reduction in wait time is critical as it enables doctors to diagnose patients faster and prescribe treatments earlier.

Dr. Edward W. Hook III, a Professor of Medicine and Epidemiology at the University of Alabama, Birmingham notes that "an on-demand test capable of delivering accurate results while patients are still present in the clinic provides a much needed advantage [and is] especially important for patients presenting to Emergency Departments and in managing patients who may not return for treatment.”

Theranos will transform emergency medicine and will save countless lives that are currently ended before tests are returned and diagnoses are made. In addition, by removing transportation costs and using their patented efficient nanotainers and analytical systems, Theranos offers its services at drastically lower prices. The company provides 274 different tests, a majority of which cost below $20. While a cholesterol test typically costs $30 for insured patients, Theranos’s cholesterol test costs only $2.99, a tenth of the normal price. Theranos is striving to close the wealth-based disparities in health. Low prices for everyone allow even uninsured patients to undergo proper blood tests.

Prior to 2013, Theranos’s blood tests were limited to its two associated on-site medical centers. However, Theranos recently partnered with Walgreens to disperse Theranos technicians and equipment in stores around the country. Theranos also recently released a mobile app and website with a secure digital hub that users can visit to access their test results and find easy-to-understand graphical representations.

As technology plays an increasingly powerful role in the research and medical fields, molecular diagnostic and biotechnology companies are advancing forward. Corporations like Theranos are stepping out of the shadows to improve health care and contribute to the resolution of public health scares. As they continue to make progress it is crucial to consider how these companies could benefit those in need and those who do not have access to such accurate, fast and low cost services in developing countries.