At my previous hospital, we had Cerner Classic then Millennium and the Free Text History report (with a daily upload) worked pretty good. I am now at a hospital that uses Mediware's HCLL product and the Automatice Patient Backup Card (APBC) is better because it updates every minute. As far as regulatory, you have to have some kind of documentation that shows you actually looked up the patient history. Both places where I have worked we had a test code for History Check (you can have any canned comment you want). The tech performing the testing is responsible for answering this field and are held accountable for performing the history check. If the history check is not completed and the patient has an adverse reaction because of it, the tech answering this test is held accountable. HCLL does check the current ABO/RH & antibody screen results against the patients history but not antibodies. If the antibody is no longer demonstrating (which is what we want to happen) without looking up the history, you will not have a good way of knowing the antibody was ever there to begin with. If the patient has special needs, you need to check the history and make sure this is satisfied. Some computers check the products for special needs at the time the products are set up and some check at the time of issue (this is too late). I think you should way the effectiveness of your current process to see if you are meeting the CAP standard. It would also be good to check with CAP to see if your current process is acceptable. As an AABB inspector, if you are not documenting this manually, as a comment on the patient or with a test code that says you checked it, I would say that you are non-compliant.