Every system is set up differently. This is how we do it. If the patient is eligible for the Computer XM, you can see it in PPI (Patient Product Inquiry). When we get an order to transfuse from Order Entry, we first go to PPI to see if the patient has a current specimen, what day it was collected (so we know where to find the BBID #), and CXM eligibility. If eligible, we go to DOE, add the XM test to the accn using the Accession Add On application, then go to Result Entry, scan the BBID (we use BB armbands), then scan the blood unit number of the unit that we take from the fridge. If the patient is not eligible because there is no 2nd ABO/Rh on file, we go to ORV and see if we can find a lavender drawn at a different time by a different phleb. If so, we go to DOE and order an ABO Confirm using the Order Entry application and mark it as collected based on the container details from the tube that we found (usually in hemo). We perform the ABO/Rh and voila - the patient is now CXM eligible. Then we do the steps above. If we know the patient is getting transfused, we get it ready at the time we receive the order. But, there are times when blood is ordered "On Hold", and we do not set these up. We will make sure these patients are CXM eligible if possible. Theses are usually OR patients. If OR then needs to transfuse, they must reorder the product with a transfuse priority of "Now", call us (to make sure someone is home) and come over to pick it up. At this time, we can go directly to Dispense and Assign, select the 4th icon from the left (may be different for other facilities) which is Computer Crossmatch Dispense and do the dispense and XM all at the same time. The unit tag will print after clicking OK. The only thing I don't like about this is that it throws a XM test on to your pending list, but it will fall off after the TS expires. I have found cerner to be quite convoluted, but it is better than what we had before, which was paper. You can't do the computer XM dispense using the regular dispense routine (2nd icon from the left) because you will have to override, even if you can see that the patient is eligible.