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Contemporary issues in transfusion medicine informatics.

Sharma G, Parwani AV, Raval JS, Triulzi DJ, Benjamin RJ, Pantanowitz L - J Pathol Inform (2011)

Bottom Line: These demands present significant informatics challenges.Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation.With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Pathology Informatics, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

ABSTRACT
The Transfusion Medicine Service (TMS) covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.

No MeSH data available.


Screenshots demonstrating electronic crossmatch (EXM) in a blood bank (test) information system. (a) An order placed in the system alerts the blood bank that this particular patient is eligible for an electronic crossmatch; (b) Blood is assigned from a pending work-log and an EXM is run; (c) A compatible product is selected and; (d) Recorded in the computer system
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Figure 1: Screenshots demonstrating electronic crossmatch (EXM) in a blood bank (test) information system. (a) An order placed in the system alerts the blood bank that this particular patient is eligible for an electronic crossmatch; (b) Blood is assigned from a pending work-log and an EXM is run; (c) A compatible product is selected and; (d) Recorded in the computer system

Mentions: Electronic or computer crossmatch (sometimes referred to as EXM, e-crossmatch or termed electronic issue) is an electronic method used to confirm that a blood unit is suitable for transfusion to the intended recipient by using validated software logic to determine compatibility. First introduced at the University of Michigan in 1992, it provided an alternative to immediate spin crossmatch for ABO compatibility between the donor and the recipient, and was found to be more rapid and generally safer than serologic techniques, in eligible patients.[16–20] Requirements that are essential for the safety of an EXM are shown in Table 3 and illustrated in Figure 1. To date, the AABB and British Committee for Standardization in Hematology (BCSH) have published specific guidelines regarding EXM, and it is being increasingly accepted around the world.[20] Overall, the advantages of EXM include reduction in laboratory workload, unit expiration, transfusion requests, sample volume requirements and cost saving. Disadvantages include the requirement to have two separate and identical ABO/Rh type results in the TMS record before being able to use electronic release, the potential for failure to detect antibodies directed to low-frequency antigens since these may not be represented on the screening cells used in the type and screen assessments, the necessity of computer downtime documentation alternatives, and increased financial investment in technology.


Contemporary issues in transfusion medicine informatics.

Sharma G, Parwani AV, Raval JS, Triulzi DJ, Benjamin RJ, Pantanowitz L - J Pathol Inform (2011)

Screenshots demonstrating electronic crossmatch (EXM) in a blood bank (test) information system. (a) An order placed in the system alerts the blood bank that this particular patient is eligible for an electronic crossmatch; (b) Blood is assigned from a pending work-log and an EXM is run; (c) A compatible product is selected and; (d) Recorded in the computer system
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3046378&req=5

Figure 1: Screenshots demonstrating electronic crossmatch (EXM) in a blood bank (test) information system. (a) An order placed in the system alerts the blood bank that this particular patient is eligible for an electronic crossmatch; (b) Blood is assigned from a pending work-log and an EXM is run; (c) A compatible product is selected and; (d) Recorded in the computer system
Mentions: Electronic or computer crossmatch (sometimes referred to as EXM, e-crossmatch or termed electronic issue) is an electronic method used to confirm that a blood unit is suitable for transfusion to the intended recipient by using validated software logic to determine compatibility. First introduced at the University of Michigan in 1992, it provided an alternative to immediate spin crossmatch for ABO compatibility between the donor and the recipient, and was found to be more rapid and generally safer than serologic techniques, in eligible patients.[16–20] Requirements that are essential for the safety of an EXM are shown in Table 3 and illustrated in Figure 1. To date, the AABB and British Committee for Standardization in Hematology (BCSH) have published specific guidelines regarding EXM, and it is being increasingly accepted around the world.[20] Overall, the advantages of EXM include reduction in laboratory workload, unit expiration, transfusion requests, sample volume requirements and cost saving. Disadvantages include the requirement to have two separate and identical ABO/Rh type results in the TMS record before being able to use electronic release, the potential for failure to detect antibodies directed to low-frequency antigens since these may not be represented on the screening cells used in the type and screen assessments, the necessity of computer downtime documentation alternatives, and increased financial investment in technology.

Bottom Line: These demands present significant informatics challenges.Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation.With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Pathology Informatics, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

ABSTRACT
The Transfusion Medicine Service (TMS) covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.

No MeSH data available.