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Meditech & electronic crossmatch


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In 5.6.2 SR5 (we currently have it loaded in our TEST system for validating), Enhancement 10471 is included which is "BBK: Electronic Crossmatch". I've asked my IT person to find out what this means as far as FDA clearance is concerned.

At the end of the Enhancement it states:

NOTE: For testing and validating the Electronic Crossmatch feature, please contact your LAB Applications Specialist to obtain a copy of the Magic Blood Bank Validation Guide's Electronic Crossmatch Section.

In the text of the enhancement it also states:

NOTE: The Electronic Crossmatch feature is not available in the LIVE environment until customer validation testing has been completed and MEDITECH has received a signed copy of the Electronic Crossmatch Guide.

I'm hoping this all means it is ready, FDA cleared, and just waiting for us to validate it for our individual sites so we can begin using it!

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Meditech for an e-xm scares me. There are always quirks in MT that show up later that you didn't know existed. And not much of the system is put together logically, so I have a low degree of trust for something so critical. I haven't looked at their new enhancement yet.

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Sheri,

Thanks for the thorough update. We are still on 5.5, going to 5.6 (?what service release) soon.

I tend to agree with Mabel, I am a little nervous about this.

I am not a Missouri native, but I guess I've lived here long enough, I say "Show me!"

Linda Frederick

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We are currently validating 5.6.1 and I saw where it can be set up in the test dictionary. Once we get through with going live on the update, we will probably start "playing" with the electronic crossmatch. Our workload has increased so drastically in the more time consumining areas- aliquoting, antibody Id, etc. and our work area is too small to allow for any additional personnel (if I could even find any), that I have to come up with some way to improve the work situation for my staff so this may be the best way, if it works.

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  • 1 year later...
We've been using the electronic crossmatch with MediTech Client Server 5.62 (LIVE system) since October 1, 2009. We are loving it!

This has been a 'dream' of mine for some time now. We're still on 5.5 and I don't know if the U.S. standards are the same as our Canadian ones (most likely - they seem to follow AABB for the most part) but can you answer some questions:

1. Is it up to the tech to ensure there is two blood groups on the patient or does Meditech warn you?

2. Is it up to the tech to ensure the antibody screen is negative/no previous antibodies or does Meditech warn you?

3. Do you still have units "on hold" actually tagged for a patient or do you just 'cross' as you issue for transfusion. If you 'cross' as you issue how did nurses and physicians accept blood was compatible for their patient even though Meditech didn't show it as such.

THANKS!!!

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The way the EXM works in MediTech is that it will automatically invoke on a crossmatched product whenever all the following criteria are met:

1. You must have 2 separate ABO/Rh typings on the patient, one must be within the past 72 hours. (You can set whether or not you require 2 different specimens and/or 2 different people running the typings.) If you don't have 2 typings, it will warn you that the crossmatch does not qualify for electronic crossmatch and why.

2. You must have a negative Ab screen within the past 72 hours. (You define which antibodies you consider to be clinically significant in the Ab dictionary.) It checks the patient history against that and if there is or has ever been a clinically significant antibody, it will not allow the EXM to invoke, and the warning message tells you why.

3. If you crossmatch at the same time you perform your type & screen (that's how we do it), the product gets crossmatched then, so there really isn't any "holding" units. We tag our units at the time they are set up, so that part is actually working the same as when we did I.S. XMs. The doctors/nurses have no idea which units were electronically crossmatched, immediate spin crossmatched, or coombs crossmatched. The tag on the unit looks the same regardless of what kind of crossmatch was done. It says: Compatible? Y

You don't actually develop an electronic crossmatch "test". MediTech flips the EXM switch in your system and it will automatically try to invoke each time a regular crossmatch is ordered with a product. If it passes all the criteria, when you put the unit number in that you want to crossmatch, it just automatically completes the electronic crossmatch and you are done. If it doesn't pass EXM criteria, you get a pop-up warning box telling you that it is ineligible for EXM and the exact reason why. Whichever way you end up crossmatching, the interpretation is "compatible" and you get the same crossmatch card and Issue form.

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Can the 72 hours be extended? We currently draw our pre-admission surgical patients up to 3 weeks prior to surgery. We do not redraw them when they are admitted. Would we be able to use these specimens for the EXM in client server?

We have been using a "home grown" electronic crossmatch with Meditech for many years (and we did get our procedure approved by FDA), but we have not changed to the Meditech provided software yet. Our biggest question is the 72 hour rule.

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The way it is currently set up in our system... no, it will not trigger on any specimen older than 72 hours. We also draw some "extended use" specimens on selected pre-op patients (we only extend up to 7 days), and we are unable to use the EXM for those patients. We are also unable to use the EXM on repeated transfusions for infants < 4 mo. where we don't get a specimen. (We still have to use our "home grown" computer crossmatch for those.)

Its an "all or none" thing ... once the EXM is turned on, it will automatically try to envoke on the crossmatch you have it attached to (ours is attached to the immediate spin crossmatch) using the one set of parameters you have set in the BBK Custom Parameters dictionary (page 1). Since the "Elec Xmatch Expire Hours" is only a 2 character data field, I'm guessing it can only be extended up to 99 hours. We have ours set at 72 hours so that we don't risk compromising the 3 day rule for patients who have been transfused within the past 3 months - AABB Std. 5.13.3.2). You can also define if you require a "2nd User for Blood Type" if you are a facility that requires 2 different people do the ABO/Rh.

It would be really nice if MediTech allowed us to match the expiration of the EXM with whatever we have defined as the expiration for each blood bank specimen - so that when we changed the expiration of the specimen, the EXM trigger expiration would change with it as well.

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