We use EPIC EHR and we have been working over one year on tweaking BB ordering. Order sets are the way to go, but each service has different rules and requires unique order sets. It is a lot of work but worth it. We get a printout of the prepare order not the transfused order. This is beneficial for pre-op patients. EPIC has a duplicate order screen pop-up that is large and obnoxious for duplicate type and screen orders. It has helped some but we still get duplicate orders. We are hoping this will continue to decrease as physicians are familiar with the system. We are also using medication style orders for derivatives and Rh Immune Globulin. We meet once a week with EPIC IS, nursing clinical services, various physician services, hospital IS, BB med director, and myself as Manager of Transfusion Service. It is well worth the time investment. For downtime, we use a back-up multi-copy requisition that is later scanned into EHR. It works well. Nursing is required to enter the collection date and time as well as the collector in the EPIC system for each BB specimen collection. If a lab phlebotomist collects, nurse can enter generic lab phleb as collector, and we collect phleb name in our BB system. The collection information stays on the nurse's worklist to remind them to complete the information. We have had problems with nurses defaulting their name instead of entering correct collector. It is a massive education issue. We are a large, metropolitan, level 1 trauma center so we have a lot of staff to educate. We are also trying to use EPIC to record transfusion data (vitals, rx evidence, etc). Is there anyone else with experience in this area?