Meditech ISBT and baby txns

[s.leonard]

We are currently validating our ISBT build and struggling with how we will handle our baby transfusions. We do not routinely crossmatch babies less than 4 months old. With Codabar we built an "NPC" that we order that does not have a XM as an associated test. With ISBT, the product we will be using to make aliquots will be a CPDA unit, but with the desginated product code that would have an XM as an associated test. This product code could also be used for other patients if the baby is over 4 months or no aliquots have been removed. How is anyone handling this situation? Can an associated test be removed if a rule is written based on age?

[LaraT23]

I am thinking that you could build a rule based on age that would reflex the test if > 4 months and not if less than. Are you using Client server or Magic, and what is the version of your software ring?

[adiescast]

We don't use Meditech, but maybe our method would work for you. It does require that the techs pay attention to the patient age, since there is no hard stop on it. We do a type and screen on the baby. Information about the date the type and screen was done is entered into the baby's computer file so that everyone can tell it was done. Then when they want blood for the baby, they order a "transfuse red cells" test and include how much volume they want. That is our trigger to aliquot the red cells for them. Our crossmatch test is not associated with the product code. (This all assumes that the baby has no maternal antibodies circulating. THAT would be a whole different process).

[s.leonard]

Lara- That was my first thought as well. The problem is we have nursing OE through Cerner into Meditech and it won't recognize the ordering rules built in Meditech. We are also on an old version of Magic 5.4.

We also considered using "transfuse" as a notifier, but are concerned that if no order is created in our system and doesn't show up on an outstanding, orders could be delayed, but I do really like that idea.

I got another suggestion to answer all crossmatches as "presumed compatible" if not doing the XM. I think this is the route we will pursue.

Thank you both for your input!!!

Stephanie

[LaraT23]

I c ould not imagine having to deal with not one HCIS but two! Sounds like a mess, Cerner and Meditech. I hope that the presumed compatible thing works, it really does sound like that is the only route given your issues.

[bbbirder]

Maybe you could make the XM interpretation "P" (for presumed) and then do a rule to remove the charge if the result is P.? Never tried it, so I don't know if it would work.

Linda Frederick