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A Stepwise Telemedicine Follow-Up System for Blood Donors in a University Blood Bank: Prospective Implementation
Ronnarit Boonyarat1, Poonsup Sripara1, Namrin Boonmawongsa1
1Blood Transfusion Center, Faculty of Medicine, Khon Kaen University, Mueng Khon Kaen, Khon Kaen, Thailand.
Background:
Conventional mail-based follow-up for blood donors with abnormal postdonation results provides no delivery confirmation and precludes 2-way communication, creating an accountability gap in donor safety.
Objective:
This study aimed to implement and evaluate a stepwise telemedicine-based follow-up system for comprehensive blood donor follow-up, including follow-up for abnormal laboratory results, low hemoglobin, and adverse donation reactions, and to measure system coverage, case completion time, and donor satisfaction.
Methods:
In this prospective implementation study conducted at Khon Kaen University Hospital from June 20, 2024, to May 30, 2025, all 168 blood donors requiring postdonation were followed up with a stepwise protocol: first, a messaging service (LINE Official Account) was used for initial contact and appointment scheduling, followed by a 2-factor authenticated consultation platform (Dietz) for physician consultation, then telephone, and finally conventional mail. A purpose-developed 15-item satisfaction questionnaire with demonstrated content validity (content validity index=1.00), internal consistency, and a confirmed 5-factor structure was distributed anonymously to all donors enrolled via telemedicine. Case completion time was recorded for all 146 cases with available time-log data.
Results:
Of the 168 eligible donors, 146 (86.9%) were enrolled via telemedicine, 16 (9.5%) by telephone, and 6 (3.6%) by mail. The confirmed-contact rate (telemedicine plus telephone) was 96.4% (162/168). Because the prior mail-only system had no mechanism to confirm contact, a comparable rate was not available. The questionnaire response rate was 83.6% (122/146). The median case completion time was 1.90 (IQR 1.42-2.50) hours. Overall satisfaction was 4.44 (SD 0.27) on a 5-point scale. The dimension-level Cronbach α values ranged from 0.886 to 0.987. Completion time did not differ by sex, age, or follow-up reason (all P>.05).
Conclusions:
The stepwise telemedicine protocol demonstrated high system coverage, rapid case completion, and high donor satisfaction. A residual digital divide (6/168, 3.6% of donors were unreachable by digital means) underscores the need for hybrid follow-up strategies. These findings support broader implementation in blood banking services.
