Lara- That was my first thought as well. The problem is we have nursing OE through Cerner into Meditech and it won't recognize the ordering rules built in Meditech. We are also on an old version of Magic 5.4. We also considered using "transfuse" as a notifier, but are concerned that if no order is created in our system and doesn't show up on an outstanding, orders could be delayed, but I do really like that idea. I got another suggestion to answer all crossmatches as "presumed compatible" if not doing the XM. I think this is the route we will pursue. Thank you both for your input!!! Stephanie