Meditech ISBT Help!

[A Fiddler]

Our team is pondering how to build in CS.

In Meditech, there are 2 ways to set up Products. One way is to create a Product Group (of ‘PCLR’, for example) and list all of the related ISBT barcodes within that group. The other way is to enter each Product as a unique single product: in other words a one-on-one relationship between the unique barcode and an individual Product entry that would include the anticoagulant and 1st or 2nd unit indicator as part of the product name. Which is best practice?

[rrcc1974]

One on one for each product you will receive is the way to go.

[KKidd]

The way I built in Meditech, you have to define your product group and then as you build individual products they are assined to a group. This allows substitutions that are not identical to the ordered product. This being said, you can define more than one bar code for each product. Be careful, as you know there may be two units collected by apheresis which will have the same number but different barcodes. SO one code, one product is probably best. Computer life is sooo much fun!!!!!

:pcproblem

Edited September 2, 2009 by KKidd
add more info

[Nancy L.]

We bult product groups, then listed individual products under defined groups. For instance: Product group PC includes PCLR (several product codes under this), PCLR2 (product codes related to the second bag of a dual collection), etc. Any of the products under PC satisfies the order for any other. This alleviates the need to know exactly which product we may need to transfuse when the crossmatch is ordered. After all, the unit clerks, secretaries, etc who put the order in the computer have no idea what our inventory is and whether or not a patient would get bag one of a dual collection or bag 2 of a dual collection. With this set up, it is not a problem. Two bags with the same number is not a problem as they have different product codes and are recognized as separate by the system.

You'll need to think also about how you have your billing set up. In our case, the billing is tied to the individual product, not the product group. It took some time to set up (as I'm sure many can attest to) but once the initial set up was done, everything has gone very smoothly.

[sgoertzen]

We have product groups built for RBC, FFP, PLT, CRYO, WB, GRAN. We then built separate product dictionaries for each kind of product you receive from your donor center that falls into each of these product group categories. You have to do it this way if you are going to print ISBT labels. We make all of our products non-orderable from the floors. We only allow the floors to order generic dummy products (our menu offers RBC, FFP, PLT, CRYO, WB, GRAN). We then edit the correct product (the one we choose to set up) on to the patient's requisition in the blood bank. All products within each product group are substitutable for each other (example: you can fill the order for the generic RBC with any red cell product like LDAS1, LDAS3 or LDCPDA, etc.) We do a lot of splitting and modifying at my hospital (we are a Children's Hospital), so it is VERY important for each product code to have its own product dictionary and we could not "lump" lots of products codes to map to the same product. Feel free to email if you have questions: sgoertzen@childrenscentralcal.org

[whbb]

I setup the Product dictionary for our small market (3 hospitals) in MEDITECH. There is MUCH to consider when undertaking this project.

QUESTIONS:

1) will you be printing labels or buying pre-printed?

2) do you modify (aliquot or pool) products?

3) do you have a donor room?

4) do you ship products?

5) are you registered with ICCBBA?

6) have you talked to your blood supplier? when will they be converting to ISBT 128?

Please let me have an email address, and I will contact you directly.

[Antrita]

We have always used the unique single product codes in Meditech for ISBT labels. Our hospital chain is working on a new update which will link many hospitals together. We want to stay with the single product codes but the update has been started with the product groups. Does anyone have any more information on this? Does the FDA prefer one way over another? My blood bank IT tech is about ready to quit, so any help would be apreciated.

Antrita

[KKidd]

When we began to build our ISBT products I had the advantage of participating in a webinar. The suggestion was to have a product for each ISBT number. For our facility I used the ISBT code along with the product name. For example, if ISBT 4321 is a leuko reduced RBC it would be E4321.RBCLR. We then placed it in the appropriate group. We only built the products we would be using and can add as needed.

:confuse:

It definitely is daunting - GOOD LUCK!!!!!!!!

[whbb]

Antrita,

The FDA doesn't even care if you use ISBT 128. It just needs to be an acceptable barcode system.

Pay careful attention to these threads when members are suggestion to NOT use product Groups as your sole product (eg:PC,FP). If you will be printing labels, the printer will ONLY recognize the first product listed to print. You need a separate product for every ISBT 128 product you want to use.

[lkg1972]

I was a member of the user group that requested the Product Group dictionary. The intent was to make it easier to deal with the many ISBT products in the Blood Type dictioary. Each individual product is then created in the Product dictionary and assigned to the Product Group. For example: Product Group "PLT" would have all the apheresis platelates and platelet concentrates, irradiated, leukoreduced, washed, etc. In the Blood Type dictionary you would list the Product Group "PLT" and not have to list each of the ISBT platelets. On page 3 in the Product dictionary you may use the Product Group for substitutes if you choose.

[whbb]

Sorry I wasn't more clear. I meant to say, you should not enter in the Product Dictionary "PC" only. If you do this like what was done with Codabar and enter all the Product codes that are PC, you will only be able to print labels for the first product listed. For ISBT 128, each product needs it's own Product Code associated with it's own Print number.

Product Groups is great when validation is required because you can validate one member of the group, and you're done. Creating Product Groups was a great suggestion!

[sgoertzen]

Yes, MediTech product groups are your friend, not your enemy! You still need to have a separate product dictionary built for each product you ever need to print an ISBT label for, but that goes fairly quickly when you can copy one product to the next as you build your dictionaries. The product groups allow you to fill an order for PC, or PLT, or FFP with any of the products within that product group, and you don't have to build from scratch the compatibility tables for every single product vs. every single blood type. It greatly improved our ability to keep our dictionaries up to date as we needed to add more products, and to validate appropriately as we moved from Codabar to ISBT 128.

[LaraT23]

One important question that I have is , do you collect donors and or prepare products, will you be labeling any products? I am not doing any of those things so I built products in the product dictionary with multiple bar codes. They are all platelets anyways when they are transfused. The docs don't care if it is the second bag or what machine it came from! We are going live with CS 6.0 in July, so let me know if you need any more information.

[whbb]

My answer to that would be how easy do you want to be able to trace a unit? Split products that are prepared by pheresis will have two product codes with the SAME unit number. You will not be able to call both of these products "PC" because the same unit number can't be given to the same product twice.

Soon, facilities will be required to scan products at the bedside. It will be similar to reading medications at the bedside. This may impact your decision. I believe that the product code will be one of the required fields to be scanned at the bedside. It must match the product that is issued. Is it easy to tell a nurse that packed cells is the same as apheresis RBC? I wouldn't think so.

In spite of all of the large amount of work involved in creating new products, it made more sense to create them all. It does go quickly once you determine a system of naming all of the products.

If you "modify" products at all (pool or prepare aliquots) you will need to also trace these products. All of these products must be barcode readable.

[PaulSunV]

I agree with "whbb" it is easier to set up all possible products in the beginning than to try to remember what hasn't been done sometime in the future when it is needed. When our supplier informed us of when they were going live with their ISBT labels they forwarded to each of the hospitals that they supplied a list with bar codes of each of the products that they supplied and any possible division. I entered all of these products as outlined by the corporate Webinar and then offered my services to the other hospitals in the area that utilized that same supplier. Only one took me up on the offer and while updating their dictionary I noticed that they were using inappropriate billing codes and brought that to their attention. One of the other hospital’s lab manager fancied himself as a computer guru so declined my services and he went with the easiest method possible. I reviewed his method and thought it would be interesting and nice if it worked. Well to try and make this story shorter his transfusion department can't bring in a 2nd part of a multiple platelet apheresis.

[LaraT23]

Hmm, whbb, my understanding is that you will never have the same number twice which is the nature of ISBT. While the DIN (donatin id number) may be the same, the units will differ in that one will be first bag and one will be second bag and so will have slight differences in the unit number, and product code. What am I missing here?

[whbb]

Lara,

I'm not sure I understand what number you are talking about, but I believe you are referring to the DIN. When split products are prepared either two apheresis red cells, or red cells and FFP, red cells and platelets, etc, ALL products collected from the same donation will be given the same DIN. What keeps them separate is the use of the product code. You can have several products with the same DIN as when you prepare components (FP to FP thawed). This is why the product codes need to be defined. You won't be able to call both parts of an apheresed unit "PC".

What you may be talking about is the use of a "suffix" that was added to the end of a codabar unit number to keep track of the aliquots. Meditech has a way of tracking the aliquot by it's divisions. Our facility elected to not follow this convention because we felt we wanted to follow the guidelines set by ICCBBA where the DIN does not change (even when preparing an aliquot). Only the product code changes. Again, when we have to barcode read at the bedside, you can't have the aliquot label use the parent unit number, and then the issue slip include the suffix. They won't match. You can avoid this in Meditech by only using the "make component" routine for also preparing aliquots.

For example, we would prepare an aliquot by making a component from the parent RBC product (E0224), and prepare the component (E0224VA0). We would call these two different products and therefore we would use the same DIN without a suffix.

It can be complecated, if you give me your email address, I can contact you directly if you like.

[LaraT23]

whbb, I went to a seminar last month here in San Antonio area give by the medical director of the one area hospital that collects donors. In her talk, she suggested that I build things the way I have, with product of FRBC and the product codes under the bar codes section next to type .ISBT 128.

Please do email me and perhaps you could give me different perpective. We will not be aliquoting or using make components at all. I do not want to invest in labels.

lthedford@petersonrmc.com

[MAGNUM]

The easiest way that I found while dealing with your dilema was to build product groups, I have 8 different product groups (cryo, cryo pooled, ffp, ffpcp, pc, plt, tcryo, and wb). Once you have your groups built, you can activate all your products and on page 1 of the product dictionary input your product group in the group selection spot. Then on page 3 of the same dictionary under the substitute product field input all of your activated products plus your product group. On the same page in the substitute product group field, enter your product group. This way if the floor orders a unit of packed cells, you can pull any compatible unit from the shelf and issue to the patient because everything is tied to a group not an individual product.:coffeecup