| Learn, Adapt or Adopt |
| Healthcare Facility | |
| By Kathryn Jones | |
| Wednesday, 18 July 2007 | |
 America's Blood Centers is the largest network of nonprofit community blood centers in the nation. Jim MacPherson has been ABC’s CEO since 1986. Previously, he was the director of hemapheresis, regulatory affairs and operations research for American Red Cross Blood Services. A credited author on the subject of transfusion medicine, he is the brains behind ABC’s growing success. In an interview with Healthcare World, MacPherson discusses ABC’s most recent innovations through collaborations with its European sister organization, ABC’s relationship with the FDA and his visions of the future for the blood-banking industry as a whole. HW: What sparked your interest in the blood-banking industry? Jim MacPherson: My career in blood banking started over 35 years ago when I delivered blood at night for the Rochester, N.Y., Red Cross while I was in graduate school studying pathophysiology and public health. Along the way, (I have) done about every job there is to do in blood banking, from recruiting donors and drawing their blood to testing it. I had worked at the American Red Cross for 13 years but left to work on my dissertation research. When the ABC job came open, I couldn’t pass it up. I wanted to tap into that community-based talent to see if there was an effective way to improve blood banking nationwide. I’ve been the CEO of America’s Blood Centers for more than 20 years now. HW: What characteristics distinguish ABC from other blood centers? JM: All ABC members are FDA-licensed, and nearly one-third has European licenses. We’re a perfect example of learning best practices nationally and applying them in the communities they serve. Each center is different because each healthcare community they serve is different. Some are largely providers of blood while others get involved in tissue services, stem cell transplants, therapeutic blood and plasma exchange procedures and specialized diagnostic tests. What makes blood centers unique are that they have customers on both ends of the supply chain – and very different customers. On the front end, we have donors who want nothing more than to help save a life. About one in seven hospitalized patients need a blood transfusion for cancer therapy, sickle cell, reconstructive surgery, transplants and major trauma. On the back end, we have hospitals and patients who want safe and effective blood products. Blood centers are one of the original hospital-shared services models. Anything involving cell processing in a good manufacturing practice environment can be done in a blood center. The fact that they are not-for-profit makes them transparent, but perhaps more importantly in this time of shrinking healthcare dollars, they will only provide and promote services needed by the local hospitals and patients. HW: As the largest U.S. network of nonprofit community blood centers, how would you describe your relationship with the FDA? JM: Obviously, there is always some tension between the regulator and the regulated – as there should be. However, we’ve worked hard to be a credible resource of information to the FDA. They know we work hard to help our members implement new safety requirements through the state-of-the-art GMP training programs we have in place. In an eight-month period, we developed 15 labs to phase-in genetic-based testing for HIV and Hepatitis C in the late 1990s. So when we raise concerns that FDA may be going overboard in a new requirement, they listen. HW: What innovations or new services has ABC spearheaded? JM: For the things we can’t control, we try to get ahead of trends and help ABC become early adaptors. For example, in the early 1990s, [the] FDA raised the quality bar for blood centers. We developed training programs and quality tools so that most ABC members had no difficulties in complying with the new stringent rules. Today, no ABC center operates under any court-imposed mandate. Similarly, when hospitals in the late 1990s wanted blood centers to compete and lower prices, ABC provided education and tools so members could effectively compete while lowering costs of operations. In the early part of the millennium, as a precaution against Mad Cow Disease, the federal government required the deferral of all immigrants from Europe and anyone spending more than three months in the U.K. That was nearly 10 percent of our donor base. To help prevent blood shortages, ABC developed targeted donor recruitment campaigns. HW: What are some recent highlights of your research and development efforts? JM: Because of the innovation among our 77 independent members, each one is a “mini-lab” for new ideas in operations research. Through a partnership with a sister organization in Europe – the European Blood Alliance – the scope of that “lab” is going global. For example, we are developing an Internet-based blood-use benchmarking tool based on a less automated but effective program developed by the Finnish Red Cross. Also, soon we will be testing an Internet-based hospital blood inventory management tool that has been in use by England’s blood program for the last five years. HW: What are some future developments ABC is partaking in? JM: Our new strategic plan calls for deepening those partnerships with other organizations that can bring future things of value to our members. For instance, we’re working with the National Marrow Donor Program to help make stem cell therapies more widely available in a GMP environment. We’re working with the Association of Medical Device Manufacturers to help accelerate new blood safety innovations. We’re working with our global partners to help identify new best practices and remove unnecessary regulatory or policy barriers that hinder implementation of new safety and efficiency tools. Also, we need to work more closely with national and regional hospital organizations like the American Hospital Association to better understand the challenges they are facing so we can help our members better meet patient needs. HW: So, in a sense, you rely on hospitals and they rely on you. JM: Hospitals are both our members’ customers as well as partners. Blood centers are really hospital shared-services organizations. So from that perspective, hospitals in a community tell the local blood center what blood and cell-related services it needs and then buys them. ABC’s job is to complete the loop working with hospital groups on a national basis to determine if developments observed in a few parts of the country are aberrations or trends, and in the latter case to be sure ABC members have the tools they need to stay ahead of the curve. HW: What is your vision of the future? JM: Cost pressures on blood centers will likely cause consolidation, especially as the blood side of operations shrinks to achieve more optimal use in patients. However, the lessons learned from many blood centers, both in the U.S. and abroad, indicate huge opportunities for blood centers; namely, cell therapies and services as hospitals look to outsource more expertise to the experts. From that perspective, both ABC and its members are far larger and more influential today in setting the national agenda on blood than at anytime in our long history. We just need to keep that ball rolling along. It’s a good model because it works to the benefit of 4 million-plus patients yearly. Though I see blood centers getting smaller, I also see them providing more services. Meanwhile, ABC will do what it always has done: learn, adapt or adopt. |
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