1. Simple as 1-2-3 Home Healthcare Laboratory of America

2. Introduction Facts (Other Laboratories) Blood specimens must be centrifuged within 60-90 minutes of the draw time to secure accurate test results Failure to meet the 60-90 minute window can mean erroneously low glucose or falsely elevated electrolytes Home Healthcare Laboratory of America (HHLA) is the only lab designed specifically to serve the needs of home healthcare providers.

3. Combines the use of a stabilized anti-coagulated blood specimen with a unique, patented transport package that together maintain pre-analytic specimen integrity Allows providers to draw blood and ship it directly to HHLA without centrifuging (spinning) the blood The nurse can package the Lab-in-a Box ® and drop it off at one of the approved overnight shipping sites at any time during the day Therefore, specimen handling is simpler and specimen integrity is not compromised Lab-in-a-Box ® System

4. Advantages to Using Lab-in-a-Box ® Nurses spend less time acting as lab couriers Allows more time for patient care Reduces mileage expense Tracking lab results is quicker and simpler Lab results are faxed directly to physicians

5. Lab-in-a-Box ® Includes: Cardboard box, Styrofoam box, FedEx shipping bag, Pack, barrier, and biohazard bag with tubes; Paperwork in clear pouch: requisition, insurance form, and barcode labels FedEx bag Styrofoam box Cardboard box Insurance form Barcode labels Barrier Biohazard bag and tubes Requisition Pack Packing instructions

6. Lab-in-a-Box ® Veni-Pack Optional item ($2.95 each) that can either go in every Lab-in-a-Box ® kit or on the side in bulk Veni-Pack Includes: 23 gauge butterfly, Latex-free tourniquet, alcohol prep pad, sterile gauze pad, and an adhesive bandage

7. Using Lab-in-a-Box ® is Simple as 1-2-3 1.Drawing the Lab 2.Packing the Box 3.Shipping the Kit

8. Step 1: Draw It! Label the tubes with the barcodes provided (clearly noted on the barcode is the corresponding tube color). Complete the yellow insurance form (first time only!) Complete the lab requisition. Remember to include all ICD-9 codes or diagnosis for the patient. Draw the patient specimen utilizing the tubes indicated on the requisition for the test ordered.

9. Side Note HHLA uses plasma collection tubes vs. serum tubes….tube colors will be different. Using HHLA requires more tubes in some cases but less volume of blood. Example: Most Labs require a red (or SST) 10ml tube for a CMP, HHLA requires that three tubes be drawn but the total blood volume is only 8.7 ml.

10. Step 2: Pack It! Place the labeled tubes inside the biohazard bag and place the paperwork in the outside pocket of biohazard bag Place the biohazard bag and contents in bottom of the Styrofoam box Place the barrier on top of the biohazard bag(s) Add additional patients (under barrier) as you collect them throughout the day Pack the specimens and paperwork in the following order

11. Place the appropriate Pack on top of the barrier (Follow specific instructions included on top of the cardboard box) Place lid on Styrofoam box Place the Styrofoam box inside the HHLA cardboard box Place the box in the FedEx diagnostic pack provided Step 2: Pack It! (cont.) Pack the specimens and paperwork in the following order

12. Multi-Packing If you are doing multiple draws during the day, use multi-packs for additional patients. Multi-packing allows you to ship several patient specimens in one box and saves nurses time. A multi-pack consists of the biohazard bag with tubes and paper work needed for a lab draw.

13. This is how the multi-packing process works: Use a Lab-in-a-Box ® kit to draw your first patient. Package it as normal. Stop before putting the box in the Fed-Ex bag at this time. Move on to your second patient. Use a multi-pack for your lab draw, placing specimen and paperwork in biohazard bag. Open up the Lab-in-a-Box ® you used for your first patient and place this second sample in the bottom of the box on top/beside the first. Continue this multi-packing process until you have as many samples in the box as you are going to ship together. Then place the Lab-in-a-Box ® in the Fed-Ex bag for shipping. Multi-Packing

14. Step 3: Ship It! Ship the packages by dropping them off at any convenient staffed location or indoor drop box. OR Call Federal Express and schedule a pick-up at your home or office (The FedEx airbill is completely preprinted except for the date the package is shipped). Note: Please call to schedule your pick-up the morning of your collection. Federal Express 800-463-3339 Press the 0 key to speak to an attendant. (Do NOT use automated system, speak to a live person) Make note of pick-up number and keep top copy of airbill.

15. Results Results are reported the next day (same day kit arrives in lab) and faxed to your location as well as the ordering physician. The lab report has trended lab results, meaning current results along with three previous results. Also included is documentation of doctor fax status on the bottom of the report.

16. Days of Operation Monday – Saturday DO NOT use HHLA for: STATs, Sundays, and Holidays You can draw/send blood on Fridays; HHLA is open to receive tests/specimens on Saturdays

17. Reordering Supplies Simply choose one of the following methods: Order via our website: http://www.hhla.com/kitorder.htm http://www.hhla.com/kitorder.htm Call our shipping department directly at: 866-651-1251 Fax a list of needed supplies to 615-771-0335 Be sure to include Company name, contact name, address, and phone number

18. Home Healthcare Laboratory of America Thank You!