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We have no problem with patients once admitted, they all have a hospital wristband and we use the MRN as an armband number throughout their stay. What is being proposed is no armband what-so-ever for preadmits which are like outpatients until the day they actually arrive for their procedure and are then admitted. For facilities who don't use an armband, what process do you use to confirm the patient registered is the same person who comes later to have pre-op blood drawn and is still the same person receiving a transfusion later? Yes, right now we use the Typenex band and we know the patient doesn't wear it and often forgets it. But if the nurse comes to pick up blood without the Typenex number we redraw the patient and repeat the testing. Our pathologist wants us to completely forgo the armband and somehow have such a good patient identification system that we don't need an armband. The problem is that the lab does not perform the registration for these preadmit patients. The patient is usually not physically present until they come for pre-op blood and they complain about the armband. Then they actually arrive for their surgery days later and by-pass the lab completely. The whole thing is just scary. Suzanne

I would be very interested to know how other facilities are handling specimen collection on preadmission patients who do not have hospital armbands. We have always used Typenex bands but of course the patients don't want to wear them and practically speaking, they fall apart after a few days. Our pathologists want us to completely move away from Typenex armbands and not necessarily have ANY armband. But what steps do you use to ensure patient identification? When products are issued what is the link back to the specimen? How are your preadmission registrations performed? Is the patient present? Is there positive identification such as a palm scan or photo ID when the patient physically presents at the hospital and is this confirmed later before transfusing? I would greatly appreciate any feedback. Thanks much, Suzanne Voh

We went live with HCLL and ISBT simultaneously in early March this year. I'm not quite clear what your friend is asking - is she questioning that the check digit should or should not appear in the issue form? HCLL displays the full ISBT DIN number including the check digit throughout the system. If you scan the barcode, the check digit displays following a dash. If you type the unit ID, you type a dash and the check digit. Suzanne

If any other HCLL users out there could confirm this behavior I would appreciate it! When a unit in the orphan file is edited, specifically the patient name, it does not update the patient name column in the Inventory module which leads to confusion. However, if you view the orphan information it is correct and the unit matches up appropriately with patients when they arrive. Thanks

We will be live in a couple weeks on both HCLL and ISBT together, transitioning from Hemocare and generic product codes. We never implemented full Codabar in Hemocare though products always came with a complete Codabar label. Our donor center has been delaying going to ISBT until the hospitals they serve are also ready (we've been holding up the show a bit). They will draw, process and label all donations as ISBT after March 3. You are lucky if you only have to configure about 20 products! Are you helping configure only the donor side or also transfusion?

I don't want to mix things up but in HCLL Transfusion the ISBT Product Code table initially was populated up to E4026. A spreadsheet with the balance of units up E5582 was available from Mediware last fall. I can't speak about the Donor side. Maybe somebody out there can fill us in? Additionally, on the Transfusion side the Product Code table you would add all the products you actually receive and make through modifying. It sounds like that would only come from what you draw in the donor center since everything else comes from ARC.

Hmmm, I wonder what spreadsheet that is? The current one has everything from E0001 through E5582 including whole blood, thawed products, everything! So you have no hospital interface for orders and results?

Yes Mediware can provide a spreadsheet with all of the ICCBBA product codes to load into your ISBT Product Code table. But this is only the beginning. Every ISBT product which you will receive plus those which are the result of modifying also have to be in your general Product Code table. The ISBT Product Process table needs rows configured for each specific product you thaw, wash, pool, etc. Each ISBT product code and related processes are added to the Billing Capture Definition (a bigee). A lot depends on your policies, how you divide, charge for attributes, etc... Check the Flow Sheets for the build process at the back of your DBA Install Guide. I'm not familiar with the Donor side but it should generate the unique DIN based on your ICCBBA source code, on the Transfusion side it will also generate a unique DIN for products requiring one (a pool for example). Are you interfaced to a lab or hospital system?

So tell me, are you using HCLL in the donor center or in the transfusion center (blood bank)? When will your supplier start deliver ISBT labeled products? You need some sample copies of the exact labels they will send to you. When did you start the building process? Is your HCLL already configured for Codabar? There several time consuming tables to configure for ISBT. You almost have to use spreadsheet uploads to get the data into the tables. I don't know about 5/1/08 - that sounds impossible. Are you interfaced with a HIS or LIS? What about your billing? My apologies for the running questions...

Hi, I said HCLL cannot print 4x4 but I meant only for the dividing process prior to v.2.9.3. HCLL works in conjunction with HemaTrax software on a Digi-Trax enabled printer. If you pool, for example, it prints the complete 4x4 with a new Unit ID as a result of the modification process (including the ABO and new expiration date, etc.). You should have an Implementation Consultant to help you through all of this. What is your projected timeline?

Can you elaborate a little bit? Won't your donor center be doing the ISBT labeling including the DIN and ABO as part of their processing? You would only print new full face labels for products you further process which aquire new unit IDs (splitting and pooling for example) I believe. Incidentally, HCLL is unable to print 4x4 full face labels prior to version 2.9.3. We are also in the process of going to HCLL and ISBT simultaneously.

The start byte for ISBT unit numbers is '='. Maybe you need to program the scanner for Code 128? Check the user manual here: http://www.iepos.com/support/symbol/ls1004userprogrammermanual.pdf

Are any HCLL users up with (or ready for) ISBT yet? We are having difficulty understanding how the ISBT Product Process table works. It seems to have the correct information yet we are not getting the correct product choice as the result of processing, in particular pooling for exchange transfusion. Any advice or pointers would be appeciated. Suzanne:pcproblem

Hi, I'm passing along a question from another facility also in the process of implementing HCLL. They are having an issue with the Hematrax codabar product code label. The last row of information regarding temperature is not printing. All required data (store at 1 - 6 C, etc...) is built in the HCLL configuration table. This is not a stand alone label system. Any ideas? Thanks

Our go-live is in Nov 07, we have been working on implementation since Feb 07. It has been an intensive and resource demanding project. We are facing ISBT at the end of the year from our supplier so must be ready. We have a project manager, almost 2 FTEs of CLS personnel, and two IS people who are spread across several other projects as well. There have been workarounds for specimen collections and order/test processing and resulting. Interfacing with our HIS has been a challenge. We will handle reagent labeling similar to Julie in Ft. Lauderdale. Specimen collection and labeling will go through our LIS.