Something I had penned down a year ago which didn’t see the light of day until now

How Chatbots can help with blood donation

Ah, donating blood! A noble yet scarce deed that people do.

There was a time when people were professional blood donors.

Yes. You read that right. People got remuneration for their donation.

The Supreme Court of India put a stop to that in 1998. That was because of a variety of reasons mainly because these professional blood donors didn’t follow standard practices and most of them were IV drug users.

Well, if you think we’ve solved the crisis, you’re dead wrong. The current state of affairs when it comes to blood donation is abysmal.

Blood banks face a massive shortage of blood — 1.9 million units in 2016–17.

We may have gotten rid of professional donors but to eradicate the shortage, hospitals have now begun making the patients who require blood transfusions find a replacement donor. This donor is usually the next of kin who often has to (un)willingly donate blood.

You see how that can be problematic right?

Let me elaborate.

To be eligible for blood donation a person needs to fulfill certain criteria, failing which, they cannot donate blood. Before donation or after, the blood also needs to be screened thoroughly for a myriad of diseases.

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This protocol isn’t always followed.

Abysmal indeed!

So what do bots have to do with all of this? How can a few lines of pre-programmed code help people in need?

To understand that, let’s take the DeLorean and go back to the past.

Integrating chatbots to help automate menial tasks isn’t a new concept. In fact, several Indian start-ups applied this logic to blood donation.

Among them was BloodLink, an Indo Danish company. The founder, Amit Lohiya, learned from experience the chaos that is blood donation. His father was in the hospital undergoing a kidney transplant and needed a blood transfusion. Lo and behold, he was asked to find replacement donors.

This motivated him to look for a solution and BloodLink was born.

The aim?

To connect

  • Donors with blood banks and hospitals
  • Blood banks and hospitals with each other

To that end, his tech team created a chatbot in 2017. The chatbot was designed to work on Facebook. It used Artifical Intelligence and Machine Learning to communicate with users. Simply put, it had a few pre-programmed answers and Machine Learning allowed it to adapt based on the answers given.

Facebook was chosen because of its potential user base. Young city-dwellers already spend several hours using it every day.

Just to give you a heads up, BloodLink was working to solve a ton of problems and chatbots can potentially fix them all.

Poor Knowledge about Blood Donation

People are often under the misconception that blood donations hurt or that they will become grievously ill after donating blood. Before you think this is a problem prevalent in the rural areas alone, young people too have certain misconceptions.

While Moral Science and Value Education classes are usually drilled into the minds of young people, basic knowledge about blood donation is not.

People are often unaware of the eligibility criteria for blood donation leading to a lot of mayhem at blood banks.

A chatbot is instrumental in giving out vital information about blood donation. A simple checklist presented to the user can help them determine whether they are a good fit or not.

Why would someone trust a chatbot over a doctor?

Because they are machines. They are objective and it’s easier to believe that they don’t have an ulterior agenda(they really don’t).

Blood donation is need based.

We have a pretty laid back attitude when it comes to most things but blood donation takes the prize.

One can donate blood once every three months. But, you do not see people walking in to blood banks to do that.

Chatbot are able to send out timely reminders to donors. These reminders can be made as non-intrusive as possible and location based services will be able to direct the donor to the nearest blood bank.

Why will it work?

Doing something good for other people releases a bunch of the happy hormones otherwise known as endorphins. The busy people that we are want to do something good for the environment and for humanity but our standard excuse “I’m busy” doesn’t let that happen.

Perhaps, we need to be guilted into doing some good. And playing on human psychology can influence people to start donating blood regularly.

Blood storage is a huge issue.

Here’s a fun fact: Blood cannot be stored forever. The magic number is 42 days. Suddenly, The Hitchhiker’s Guide to the Galaxy makes sense.

Here’s another whopper: For patients with Thalassemia, the blood needs to be no more than 4–5 days old.

The recent regulations have come up with something known as ‘bulk transfer’. For it work, there needs to be a robust connection between donors and blood banks.

And, who better to use AI, Big Data and Machine Learning to build a database than a bot?

Chatbots work on both ends. The donors get a novelty interactive experience chatting with a bot and blood banks can replenish their storage.

Another fine example

Donor Find Kar also deserves a special shout-out. While BloodLink wanted to take it efforts worldwide, Donor Find Kar was an Indian based startup that had a model in place local to India.

Its founder, Akash Paul, intended on creating a no-spam, no-nonsense bot that could be accessed via the Facebook’s messenger.

So why a chatbot and not an app?

An app is only successful if it can engage its users and retain them. With memory constraints and loads of apps that are used daily, which app do you think is going to get the axe?

The blood donor one!

Because, blood donation is need based.

Chatbots eliminate the need for a separate app.

Using the Facebook Messenger or any other messaging app for that matter works brilliantly because these apps are already installed on people’s phones.

It is then easy to reach out to people in need and for people to be notified of a local request.

Winner: Facebook

Facebook beat Donor Find Kar to this and launched its own initiative this year. 6 million Indians have already signed up to become a blood donor.

Becoming a blood donor is as easy as ABC. Signing up only involves one step with a 2 part question.

‘What is your blood type?’ and ‘Have you donated blood?’

Another reason why blood donation doesn’t happen as frequently is because the process is time taking. Donors are often turned away by hospitals and blood banks and asked to come in later on account of them being preoccupied.

Chatbots prioritize donors

The Facebook bot is simple yet effective. After signing up that takes less than a second, users can respond to requests in their area.

Chatbots notify users about requests

If you’ve got your location services on, Facebook will connect you to a request in your area. Even if you don’t, Facebook uses other algorithms to figure out your location to show you relevant requests.

Bots keep track of your last blood donation

A minimum of 120 days between each donation is recommended. Bots can keep track of this by asking users to let them know whether they responded to a certain request and verifying it with the person who requested it. It then refrains from sending out a notification for 3 months.

Bots guide you to a medical professional

In case you’re still in the dark about whether you are an eligible donor or not, the bot is your friend. Apart from falling into the right age group i.e. 18–60 and having a sound mind and body, there are certain dangers with blood donation.

The risk of diseases.

Problems with the bot that no one talks about

In my opinion, Facebook hasn’t overcome this problem. Saying go see a doctor isn’t enough and here’s why:

First, sex is a taboo in India so to discuss STDs, STIs or HIV isn’t exactly dinner table conversation let alone talking about it to your doctor.

Second, there is a window period with most diseases.

HIV, Hepatitis A, B, C and even malaria has a window period. So if someone were to contract HIV today and donate blood tomorrow, the test wouldn’t be able to pick it up.

The generation of the ELISA test used to test HIV determines the window period. The third and fourth generation tests reduces it to about three weeks. Every blood bank doesn’t administer newer ELISA tests.

Newer technology such as the Nucleic Acid Amplification Test has emerged. This brings the window period down to a mere 7 days. But, it brings up the cost of blood per unit from 2000 to 2500 INR.

‘So what?’ you may think. The National Aids Control Organisation has a policy wherein the price of whole blood per unit is capped at Rs 1,050 per unit of whole blood in a government institution and Rs 1,450 in a private institution.

Shouldn’t blood be given free of cost? Technically yes but just like clean water, blood comes at a price. Only patients suffering from Thalassaemia, Haemophilia and sickle-cell disease get free blood in Government hospitals.

But, states such as Karnataka have made the Nucleic Acid Amplification Test mandatory in all their government hospitals. Other states like Maharashtra wish to follow suit.

India vs. Developed nations

Another drawback with the Facebook’s chatbot is their lack of understanding of the Indian blood donation scenario.

Despite the window period being a limitation, many countries have not reported a single case of HIV transmission through blood transfusion.

1985 was the last time Canada reported transfusion-transmitted HIV cases. USA isn’t far behind. The last known case of HIV transmission occurred in 2008.

1 in 2 million donations

That’s how low the risk of a disease spreading through transfusion is in the US.

HIV or even something as trivial as a viral infection hasn’t been transmitted through transfusion in the UK since 2005.

India, on the other hand, has a whole other story to tell. No less than 2,234 people reportedly contracted HIV through a blood transfusion in the last 17 months. This information was made public by the The National Aids Control Organisation due to a Right to Information plea filed by an activist Chetan Kothari.

Out of all the blood collected, approximately 0.2% of the donated blood units test positive for HIV. Understandably, this blood is removed from storage. But, the ones that slip past due to the window period dilemma can go on and infect healthy people.

A hospital in the outskirts of Mumbai was recently ordered by The National Consumer Disputes Redressal Commission to pay Rs 12,000 to a patient who had contracted HIV 20 years ago after blood transfusion. An amount too low to cover all the medication that will be needed to keep her alive but seeing how the court ruled in favour of the victim is clearly a sign of progress.

Let’s not blame it all on the bot

Perhaps, the onus of a proper screening isn’t on Facebook. It is merely a medium to connect receivers and donors.

We could take a few cues from Canada where blood donors are given counselling at length. A proper screening is done and several parameters are in place to prevent infected blood being transfused.

Chatbots help blood donors navigate tricky questions

The Facebook bot can be tweaked for India by adding a questionnaire that asks people otherwise uncomfortable questions and indicate whether the person is eligible or not. A company in US spends anywhere from $5 to $10 on each donor appointment. Bots can do the same thing and for mere pennies.

Verdict

Bots save lives. They also save time and money. Naturally a few adjustments need to be made but it is definitely a step in the right direction.

This non-intrusive system can potentially eradicate replacement donors, fulfil shortages and prevent blood from getting thrown down the drain.

‘Help is always given those who need it,’ Dumbledore’s words live on through these blood donor bots.

Don’t forget to give us your 👏 !

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How can chatbots help with blood donation? was originally published in Chatbots Life on Medium, where people are continuing the conversation by highlighting and responding to this story.

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