A Stepwise Telemedicine Follow-Up System for Blood Donors in a University Blood Bank: Prospective Implementation Study.

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.