Mediware HCLL for Transfusion

[QRISTOFIR]

Is anybody familiar with the HCLL software for Transfusion by a vendor named Mediware? We're in the processing of purchasing it and should be running in a year or so. I'd like to hear from folks with experience using it well before it arrives in a computer near me.

First question is what kind of patient identifiers does it support? SSN, Medical Record Number, Armband Number, or is it fully customizable? I am currently in a gang on a mission to revise our hospital's patient identifying methods.

Thank you.

[L106]

Hi QRISTOFIR.

[QRISTOFIR]

Hi QRISTOFIR.

I was actually expecting a little more than "Hi" in response to my question..... But I can return a warm gesture............ HELLO!

[L106]

Hi QRISTOFIR. We have had HCLL for our Transfusion Service for over 5 years. It's not perfect, but we are very pleased with our choice. I think it's more user-friendly than other systems we looked evaluated at the time, and training for new staff members seems pretty easy. I can't even remember the last time our system was down because of a problem.

It can support SSN, Medical Record Number, and Armband Number. I can see the patient's SSN in their HCLL admission record, but we never really use that number. (I'm glad, because I don't think staff needs to be dealing with patients' Social Security Numbers.) We use the patient's Medical Record Number and the Typenex-type Armband Number.

Let me know if you have any other specific questions.

Donna

[QRISTOFIR]

Thanks much Donna. I knew you had a lot more than "Hi" to say but your keyboard/mouse probably had their way. Your reply actually puts my questions to rest for now but if new ones arise, I'll be sure to post them here on this thread.

[L106]

You are exactly right! I started typing and my keyboard went nuts! Sorry!

Donna

[Likewine99]

We have been up on HCLL for almost 3 years. We use the pt identifiers as L106 stated, we use an in-house BB armband system.

It is not a perfect system but we customized it to fit our processes with very little change in the dept workflow.

This is a great place to post questions, keep them coming!

[QRISTOFIR]

Thank you Likewine99. Everybody seems to make sure they state that the system isn't perfect. No system is, but I'm just hoping this is not "subdued buyer's remorse" that turned into resignation to a signed, sealed, delivered, and implemented HCLL that's going nowhere. Just kidding!

With current knowledge and experience, would you have picked something different if you had the luxury?

[L106]

Based on the other systems we evaluated back 5 years ago, yes, I am glad we selected Mediware's HCLL.

Today....I don't know, because I haven't looked at any other system during the past 5 years. From comments I have heard from other system users, it sounds like some of the other systems have improved during the last couple years, and other systems have taken steps backwards and have actually become less attractive to users.

[Likewine99]

Our organization made 2 site visits, to a live HCLL site and another vendor's live site. I was not on this team but had confidence the right people attended the demos. The other system was deemed "too clicky" and more "cumbersome" for our end users than HCLL. Not all of our BB staff are dedicated to BB, esp on evenings and nights.

That being said, the current HCLL is more clicking steps that our legacy system. I do feel we made the right decision and 3 years post go live we are not suffering "subdued buyers remorse".

As you look at systems get your staff level techs involved (if staffing allows!) and keep an open mind. Don't be afraid to examine your current practices and workflow (especially the ones you find most cumbersome right now).

If you go on a site visit ask the staff using the system "what don't you like about it" and "what does this system do for you that your old system didn't". And make sure what they say the system can do is current functionality and not "in development".

Good luck and keep posting!

[L106]

Excellent advice, Likewine99!

[dmpollock]

We currently have Sunquest with interfaced Galileo ECHO instruments. Our facility will be moving to HCLL. I am expecting a significant drop in productivity, and in some cases patient safety.

With Sunquest most functions can be accessed through keyboard shortcuts, reducing the need for constantly switching between the keyboard and the mouse. Experienced typists can move very quickly on the system. With HCLL it is impossible to use the system without constant mouse movements. HCLL does not meet current guidelines for GUI interface, which require "accessibility options" for people with disabilities. I pointed this out to the trainer while at the company's training center. The response was shoulder shrug and a "so-what" expression.

With our current setup we perform donor confirmation of ABO and Rh on the ECHO, with the results electronically interfaced to Sunquest. We have a great deal of confidence that our units have the correct blood type in the system. The HCLL trainer stated that the system can't interface donor confirmatory testing with an analyzer! This was a surprise since the company brags about their focus on patient safety.

If you look at the processes used for an electronic crossmatch, there are requirements focused on accuracy of the patient's blood type (such as testing the blood type twice), but insufficient consideration has been made for the unit of blood. Although it is infrequent, it is entirely possible for the donor unit to have the wrong blood type in the computer. For example, when receiving a shipment of units where multiple units are laid out on the counter, the tech might scan the unit number for one unit, look at the screen to make sure it took the data, then look back at the counter, become confused where they are in the scan process, and scan the ABO barcode on a different unit. There are additional scenarios where this can happen.

When entering data into a computer, people sometimes err by entering expected values rather than actual values. For example, I recently saw a case where multiple units had confirmatory testing entered without the tests being performed. There were several hospitals sharing the same database. Hospital A received 7 O Pos units. Hospital B received 6 O Pos. The tech at Hospital B performed confirmatory testing on his 6 units. He picked the wrong batch of units and entered negative results of the the anti-A,B test for all 7 units that were at the other hospital. He did not notice that he tested 6 units but resulted 7. (He also did not check the unit numbers.) This error would have been prevented by performing the tests on an instrument with barcode labeled specimens, and interfacing the results.

When there are combinations of these mishaps errors can make it all the way to the patients. HCLL needs to be able to interface the testing for facilities that want to use analyzers.

As you can guess, I am not in favor of our switch to HCLL at this time. For what it is worth, I have been doing blood banking and computer programming for more decades than I want to admit. I also have some experience with computer-assisted error-proofing in maunufacturing logistics.

[DPruden]

We have been using HCLL Transfusion since the end of 2007. I was not here for the go-live, but it was a bit rocky at first. That being said, I think it is a good system. Mediware has fixed a lot of the issues that we saw at the beginning. We have our Echo interfaced to HCLL, but do not currently perform donor confirmations on the Echo (it was more trouble than it was worth). I do agree that it is a bit "clicky" but there are keyboard shortcuts just like any other windows based program. It seems to be very easily learned by people who are comfortable with windows based programs. I would suggest taking a good look at your current processes and don't just create them the same way in the new system automatically. Once the truth tables and tests are built, it is much more difficult to change them.