Electronic Crossmatch

[YorkshireExile]

We are currently validating the use of electronic crossmatch in our hospital. For those hospitals who currently do EXM, if the DAT is positive does that mean that sample is not valid for EXM? If so, how did you validate this? We are having difficulty to make a positive DAT part of the criteria for EXM exclusion. All we can think of is to add Positive DAT to the list of antibodies under antibody ID so it would then be recognised. The computer system we are using is Cerner Millenium.

 

Edited November 19, 2019 by YorkshireExile

[cheru26]

Positive DAT does not disqualify from being eligible for electronic crossmatch.  The requirement for electronic crossmatch are listed  on AABB standard.  
 

[Ward_X]

Independent entities. For example, if a sample is pending an eluate, but the screen is negative, you can still EXM.

[YorkshireExile]

Thank you for the replies.

What about another couple of scenarios we are considering.

If an automated blood group is ever edited for any reason, does that disqualify from doing the EXM?

If for some reason a RBC unit is not entered electronically into your inventory in the computer using the barcodes, but is instead entered manually, does that disqualify from doing the EXM?

[Malcolm Needs ★]

I would suggest that you go to the BSH Guidelines site, and read their Guidelines on computers.

[Ward_X]

11 hours ago, YorkshireExile said:

If an automated blood group is ever edited for any reason, does that disqualify from doing the EXM?

My facility uses HCLL 2016. If a type has to be manually edited or adjusted, the type turns red and they're no longer EXM eligible until the type "discrepancy" is resulted -- which, has to be corrected by a senior technologist. Logic wise, the software is missing two matching blood typings that would allow the patient to be electronic crossmatch eligible.

[Byfaith]

On 11/19/2019 at 11:43 PM, YorkshireExile said:

Thank you for the replies.

What about another couple of scenarios we are considering.

If an automated blood group is ever edited for any reason, does that disqualify from doing the EXM?

If for some reason a RBC unit is not entered electronically into your inventory in the computer using the barcodes, but is instead entered manually, does that disqualify from doing the EXM?

We use EXM on Cerner Millenium.  I'll try to answer your questions...

For Blood groups, if you ever change the ABO-Rh interpretation it will disqualify EXM.  If you are only correcting a reaction strength or something like that you can still use EXM.

RBC units not entered electronically cannot be used in EXM.  There is a workaround to remove the units from inventory if someone has manually entered, and subsequently enter them electronically.

I hope this helps!

[YorkshireExile]

Thank you "Byfaith".  it does help!  Have you ever had any problems performing EXM with Cerner Millenium? Or is it all good as long as the EXM rules are built correctly?

[ESIZENSKY]

I need some advice in building the EX XM test dictionary. Is the billing code drop at XM or at transfusion?  In Meditech 5.67

 

Edited August 19 by ESIZENSKY

[John C. Staley]

Something to consider.  If the charge drops at XM you might get paid for it.  If it drops at transfusion and the blood does not get transfused you will definitely not get paid for the XM.  Something to think about.  We dropped the charge when the XM was completed.  

Another little story from the past.  Us old guys like little stories from the past.   I was called to the billing office to "discuss" a billing issue with someone from the insurance company.  She wanted to know why we charged for the XM when no blood was issued or transfused.  I told her that the DR. had ordered the testing in the anticipation of needing the blood because the surgery routinely required transfusion.  We did the work and charged for it.  Her contention was that since the patient did not use any blood the testing was unnecessary!  At about this time I asked to see her license to practice medicine.  She became quite incensed when I told her that insurance companies had no business practicing medicine. That's when our conversation came to an abrupt end.