Bilimeters
Considerations for purchasing
Bilimeters offer midwives the ability to perform transcutaneous bilimeter (TcB) screening at the point-of-care. They are a non-invasive, quick and reliable method for measuring the yellowness of subcutaneous tissue.1
Research has shown that the digital measurements obtained from bilimeters correlate with serum bilirubin levels but are not precise enough to replace serum bilirum testing. Rather, bilimeters may be used in conjunction with clinical judgement to assess a newborn’s risk for hyperbilirubinemia and their need for serum bilirubin testing.
There are currently three bilimeters commonly used by midwives and hospitals in Ontario: the Dräger Jaundice Meter JM-105, the Bilicheck System and the Bilicare System. All of these devices are currently used by Ontario midwives and in Ontario hospitals.
The AOM evaluated the technical specifications, maintenance requirements, accuracy and cost of the JM-105, Bilicare and Bilicheck devices. This evaluation was intended to aid understanding of the best available bilimeters for midwifery use and to support decision-making. For a detailed comparison, see the table below:
Dräger Jaundice Meter(JM-105) |
Bilicare System |
Bilichek System |
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Accuracy in All Skin Tones – Standard Error of Estimate2 |
± 27.4 µmol/L at 66% of the time | ± 26 µmol/L at 66% of the time | ± 26 µmol/L at 66% of the time | ||
Accuracy in Darker Skin Tones3 |
The JM-103 model slightly overestimates TcB in darker skin tones. (1) | Research specific to darker skin tones cannot be found. | Slightly overestimates TcB in darker skin tones, but overestimation is less profound than JM-105 device. (1) | ||
Measurement Location |
Forehead, Sternum | Upper part of the ear | Forehead, Sternum | ||
Prior to Use Requirements |
Manufacturer specifications state that each new or recently calibrated device requires validation prior to clinical use by comparing the first 30 TcB readings to serum bilirubin readings within one hour of sampling. In addition, a “light check procedure”4 must be performed successfully each day regardless of clinical use. The values obtained must be recorded. |
A calibration tip must be applied to the device before use. An optional disposable tip cover may also be attached overtop of the calibration tip. |
Internal calibration occurs automatically with the application of a new disposable tip. | ||
Portability |
Must carry bilimeter and docking station. Docking station must be plugged into an electrical outlet to function. |
Must carry bilimeter and docking station. Docking station must be plugged into an electrical outlet to function. |
Must carry bilimeter, extra battery and disposable tips. Charger for battery can be plugged into a car or a standard electrical outlet. |
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Size and Weight |
Device weight: 203 g Width 5.6 cm Length 16.8 cm Depth 4.5 cm |
Device weight: 160 g Charging dock weight: 100 g Width 5.7 cm Length 15 cm Depth 2.3 cm |
Device weight with battery pack: 250 g Width 5.23 cm Length 20.45 cm Depth 5.94 cm |
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Recommended Calibration |
Annual calibration through Draeger Medical Canada Inc. in Mississauga, Ontario.5 Routine “Light Check Procedure” ensures the JM-105 is properly calibrated.
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The device utilizes LED lights that do not require routine calibration. Calibration can be checked manually at any time after a calibration tip is applied. |
No periodic calibration; automatically recalibrates when new tip is applied. | ||
Cleaning Requirements |
The JM-105 device and charger base may be cleaned with the following agents:
Entire unit can be cleaned with a wet cloth, gauze sponge or soft bristle brush that has been soaked in alcohol or netural pH medical instrument detergent that is diluted in water. The JM-105 cannot be cleaned with benzene, solvents, or thinners. Cannot be exposed to excessive moisture that would allow for liquid pooling. Has a cork bottom which cannot be disinfected. |
Q-tips soaked in 70% Ethanol solution should be used to remove any residual of debris from the earpiece area. Isopropyl Alcohol 70% pharma wipes should be used for wiping the earpiece area. The contact time of the alcohol should be at least 10 minutes.6 The plastic outer surface of the device may be cleaned with a soft, lint-free cloth dampened in a mild soap and water solution, ethyl alcohol (70-85%) or isopropyl alcohol. |
The BiliChek System surface may be cleaned with the following agents:
May be cleaned by spraying the cleaning agent of choice onto a damp cloth and wiping the BiliChek system and display window clean. The optical measurement tip should only be cleaned with 90% or higher Isopropyl Alcohol using a soft optical surface cleaning wipe. Discard disposable tip after use and apply new tip before use - do not attempt to clean and/or reuse the disposable tip. Cannot be immersed in water or other liquid. |
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Battery Life and Considerations |
May be turned off manually to preserve battery life. Will turn off automatically when not in use for 1 minute. A fully charged battery lasts up to 200-300 readings. Battery life can be maintained by placing the device back into the charging dock when not in use. Battery cannot be replaced by the user; must be sent to an authorized service. |
A fully charged battery lasts for about 100 readings. The device will take 5 hours to fully recharge after being drained. Battery cannot be replaced by the user; must be sent to an authorized service. |
Cannot be turned off manually. Will automatically activate “stand-by” mode when not in use for 1-2 minutes – battery continues to drain when on stand-by mode. A fully charged battery lasts 6-8 hours. Some battery life could be maintained with a car charger. Battery requires charging every night (full recharge takes approximately 8 hours). May replace battery in device with spare second battery. |
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Storage Space |
100 sample readings | 40 sample readings | 31 sample readings | ||
Ease of Use |
Requires minimal training to obtain reading. | Requires minimal training to obtain reading. Training videos are publicly available on the manufacturer’s website. | Requires moderate training to obtain reading. | ||
Midwifery Device Cost to Outright Purchase |
$8,900.00 | $6,245.00 | $5,950.00 | ||
Leasing Cost @ 60 Months Lease Term |
$216.44 per month (includes device, annual calibration and battery) |
Leasing options available through an external company Contact the manufacturer for more information |
$123.50 per month (includes device, battery, and calibration tips) $169.00 fee for initial leasing paperwork |
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Extra Costs |
Yearly calibration fee: $340.00 |
60 tip covers: $175.00 3 calibration tips: $120 Battery replacement: $225.00 |
50 tip box: $225.00 Single tip: $4.50 Extra battery: $60.00 |
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Location of Servicing |
For all calibration and servicing needs, devices are sent to: 2425 Skymark Ave #1, Mississauga, ON L4W 4Y6 |
Various servicing (i.e., battery replacement) can be completed through AshconMed in Burlington. Device must be shipped to a facility outside of Canada for repair, calibration, and software updates (United States, Israel or United Kingdom). Repairs under warranty must be made by an authorized repair center. If the device needs repair, contact the product distributor. |
Devices in need of servicing may be sent to a Canadian distributor or to Respironics in the United States (Pennsylvania) based on the company that receives the servicing request. | ||
Last reviewed and updated: October 2025
Footnotes
[1] The yellowness of subcutaneous tissue correlates with the amount of bilirubin present in the blood.
[2] This standard error provides an estimate of how similar the sample mean is to the population mean. A smaller standard error indicates superior accuracy when compared to a larger standard error. In this case, the Bilichek and the JM-105 are almost identical in accuracy.
[3] A study in 2016 that compared the accuracy of the JM-103 and the Bilichek within a population of African neonates found that both devices significantly overestimated TSB levels. (1) However, the JM-103 was found to be associated with slightly greater imprecision than the Bilicheck overall. The available research does not record the age in hours of neonates during bilirubin testing and therefore it is difficult to determine the clinical significance of these results.
[4] The light check procedure involves pressing the tip of the JM-105 device into the checker circle located on the charging dock. The display screen of the JM-105 will show delta values that must be within a particular range in order to use the unit. These values must be recorded daily in the handbook that came with the device. Daily records ensure that midwives have properly documented that the device is appropriate for clinical use.
[5] The JM-105 must be shipped to the facility once a year and a replacement device is not available during this time.
[6] For proper disinfection, it is necessary to keep a surface wet with alcohol for 10 minutes, but this can be challenging because alcohol evaporates quickly. It may be necessary to reapply the alcohol a number of times during the 10 minute wet period. Using the disposable covers adds additional protection, but does not eliminate the need for disinfection.
[7] This assumes that there are no complications with the device that are not covered by the warranty. For damages not covered by the warranty, repair costs vary with the severity of damage to the device.
Reference
(1) Olusanya BO, Imosemi DO, Emokpae AA. Differences Between Transcutaneous and Serum Bilirubin Measurements in Black African Neonates. Pediatrics [Internet]. 2016 Sep;138(3). Available from: http://www.ncbi.nlm.nih.gov/pubmed/27577578