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Diagnostics at Home: Mately Uses Blood Spots to Track STDs

By Rory McCann

August 4, 2016 | Healthcare innovation is connecting with patients in ways that are easily accessible, low cost, and convenient. Mately is doing that via a new, at-home, sexually transmitted disease (STD) screening system. Mately’s Chief Scientist, Yao Wang, thinks now is the time for Mately for two reasons. First, Mately provides a service that is easy and straightforward, and eliminates “coordination efforts”, which Wang defines as, “any steps in the purchasing process that require the consumer to expend time and/or money that is not related to the purchase in question”. Second, as STD rates rise, Mately has developed a system of frequent testing to decrease risk and raise awareness.

Mately’s system is based on monthly blood and urine sample submissions to test for potential STDs. The samples are small, and collected by the user at their own convenience. Here’s how it works: The user joins an online network and is mailed a new member kit. This contains registration information and a saliva swab. The user creates a Mately account and uploads a photo so their pharmacy can confirm their identification. Next, they visit the pharmacy, and the pharmacist looks up their photo and confirms their identity before taking a saliva swab to serve as their base-DNA sample. They do this to ensure that all future blood and urine samples match that user’s DNA on file. The pharmacy sends the sample to Mately, which then begins mailing kits that contain the tools the user needs to collect screening samples. Users return the samples to Mately directly by mail. A user does not need to visit the pharmacy again.

Users submit blood samples by pricking a finger and dripping blood on absorbent cards. Mately releases the dried blood samples via a process called elution. It’s not new technology. Wang says this process has been used for STD testing for many years, all over the world, and is even the standard for newborn HIV screening in New York state. Mately isn’t the first to use dried blood spot samples, but Wang says, “We believe that we are adapting it to the needs of consumers in Western society in a way that has not been done before.”

Mately checks its users’ HIV status through a series of two tests. The first test screens for HIV antibodies that reveal an existing infection, while the second early-detection screening is an RNA-based Nucleic Acid Amplification (NAAT) HIV test, which detects newer acute infections. If a patient has contracted HIV, they often have a window of time during which the first antibody test may not detect the infection. Because of the high number of submissions predicted, Mately is employing a technique known as sample pooling, which is a method that tests a large number of samples in a pool. If the entire pool tests negative, it is assumed that each sample is negative. If the pool tests positively, then each sample is tested to find the infected sample(s). Sample pooling is used by high throughput communities like blood banks, while many local clinics cannot use it due to a lower number of submissions. This helps users by keeping costs low and catching infections early for treatment.

Quantified Testing

Wang says, “We believe that Mately is an extension of the ‘quantified self’ movement. While it is interesting that one can monitor one’s pulse and breathing patterns during sleep using a wearable device, we feel that customers are going to demand additional data that is actionable and useful to them in their daily lives.” The web-based network also allows users to interact with their results by selecting from multiple conditions they wish to be screened for, such as Syphilis, Hepatitis A, B, or C, Herpes (Type 2), Gonorrhea, and Chlamydia. Mately also facilitates physician follow-up, especially if a patient tests positively for an infection.

Mately’s services are designed for accuracy and convenience at a low cost. Mately’s HIV screening services cost $30-per month, or $70 for a one-time screening, with additional fees for add-on tests. Users can pay less with bi- or tri-monthly screening options, or even bi-annual tests. Once signed up, the user can customize both frequency and convenience. They’ll either receive sample collection materials in the mail, or they’ll be prompted to pick them up at a pharmacy.

Wang says, “We believe that the easy access as well as low costs associated with at-home screening will encourage more frequent testing and therefore facilitate the early detection of diseases.” She says the prospective user survey responses have been positive with an initial 50% conversion rate that jumps to 90% when prospective users finish the survey. With a positive initial response, perhaps Mately will start a trend in providers remotely delivering reliable healthcare to patients conveniently in their own homes.