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Meditech - warning for patients with special transfusion requirements

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I found one topic that described this but I was hoping someone had some specific experience/guidance/rule coding for me...

 

http://www.pathlabtalk.com/forum/index.php?/topic/2990-special-product-requirements/?hl=%2Bmeditech+%2Brule#entry18397

 

We use Meditech C/S 5.66 right now. I would like an assign/issue rule for our cellular products that checks if the patient's LIS history marker (e.g. Irradiated, CMV-negative) matches to the product being selected for their transfusion. We've identified the way to do this, by adding a rule to the Product dictionary under Page 5 (i think) but our IS people haven't been able to find the right syntax for the NPR code to get it to work - it keeps crashing the application.

 

Does anyone have an example of coding that works for them that they would be willing to share?

Does anyone have an alternative solution that they are using in their Meditech LIS?

 

Thank you in advance for your help!!

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We use a rule that gives the user  just a warning.  In the event that the BB needed to provide a product w/o the marker, we wanted to have the option to override.  This can also be set up as a "hard stop" if you want.  How we applied this was to enter this as an assignment/issue rule for PC on page 4 of the Product dictionary.  You need to create the rule in LIS Shared Dictionaries, Rule Dictionary and create a BB assignmnet rule type.  Go to Atlas and enter "Lab Rules"  and you should be directed to the Rules Catalog that provides examples of how to create different types of rules in Meditech for Lab.

 

 

;Marker Rule is used to flag patients that require specific blood
;requirements ie, HLA matched platelets, CMV negative blood.
;Marker Rule resides in the Product Dictionary.
;Marker applied to PATIENT must be the same marker applied to PRODUCT.
;
[f bpt unit mkrs comp]^X,
IF{X "Pt marker not on unit: "_X_" OK? "^X,
[f basn yes/no](X);
[f basn ok]};

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We want a similar feature - a warning without a hard stop.

 

Thank you for providing an example of your code, is what you posted copied straight from Meditech? Ours looks a lot different and more complex.... (maybe that's why it doesnt work!!)

 

Do you have the same name for your blood bank history marker and the unit marker - and that's why your argument code is so simple?

 

Thanks for pointing me towards the Atlas/Lab rules - I didn't know this existed. I'm not very familiar with the syntax/logic in NPR coding and hopefully this can help me understand.

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If your rule syntax is causing the application to crash, you need to open a task with Meditech and have your BBK/NPR specialist take a look at your rule.  It is often as simple as a space in the wrong place.

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Over my lunch break I fooled around in the test system enough to write a rule that seems to accomplish what we're looking for. I need to do more validation to see if it breaks something:

 

IF{[f bpt mkr]("TIRDBP") IF{[f bun mkr]("IRR") [f basn ok];

"Unit is not irradiated, OK?"^M1}},

IF{[f bpt mkr]("TCMVNB") IF{[f bun mkr]("CMVN") [f basn ok];

"Unit is not CMV-Neg, OK?"^M2}},

IF{[f bpt mkr]("TSICKNB") IF{[f bun mkr]("SCELLN") [f basn ok];

"Unit is not Sickle Neg, OK?"^M3}},

IF{M1 [f bbk override msg]("OTHER",M1)^T1;

[f basn ok]},

IF{M2 [f bbk override msg]("OTHER",M2)^T2;

[f basn ok]},

IF{M3 [f bbk override msg]("OTHER",M3)^T3;

[f basn ok]},

IF{(M1&('T1))!(M2&('T2))!(M3&('T3)) [f basn reject];

[f basn ok]};

 

whbb thanks for your info. I feel like being able to use [f bpt unit mkrs comp] would be a lot easier but I had to assume that your history/unit markers needed to be the same name for it to work? Using this rule will send info to the override warning report every time a product doesn't match up.

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 Go to Atlas and enter "Lab Rules"  and you should be directed to the Rules Catalog that provides examples of how to create different types of rules in Meditech for Lab.

 Where is Atlas?  Is it in the Meditech dictionary?

 

Thanks,

 

Dan

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Yes, the markers need to be the same for the unit marker and the patient marker.  They need to be on both so that the warning does not appear.

 

Sorry about "Atlas", I did not realize that it is an "intranet" connection, so it is probably only available to our network of facilities.  I would think however that Meditech should be able to direct you to online information.

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What you want to do is possible.

We've got ours set up to 'fail assignment' if the patient has the markers "irradiated products required" and/or "CMV neg products required."

For irradiated products it looks for specific products (our irradiated products have a '1' at the end of the mnemonic). For patients that require CMV neg Meditech looks for the CMV neg marker attached to the unit during receipt.

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Our IS team was able to add this to LIVE today. The final rule was:

 

IF{[f bpt mkr]("TIRDBP") IF{[f bun mkr]("IRR") [f basn ok];
"Unit is not irradiated, OK?"^M1}},
IF{[f bpt mkr]("TCMVNB") IF{[f bun mkr]("CMVN") [f basn ok];
"Unit is not CMV-Neg, OK?"^M2}},
IF{[f bpt mkr]("TSICKNB") IF{[f bun mkr]("SCELLN") [f basn ok];
"Unit is not Sickle Neg, OK?"^M3}},
"Patient is Rh neg do you want to give Rh pos products?"^X,
[f bpt btype rh p/n]="N"^PRN,[f bun btype rh p/n]="P"^URP,
IF{PRN&URP X}^M4,
IF{M1 [f bbk override msg]("MARKER MISMATCH",M1)^T1;
[f basn ok]},
IF{M2 [f bbk override msg]("MARKER MISMATCH",M2)^T2;
[f basn ok]},
IF{M3 [f bbk override msg]("MARKER MISMATCH",M3)^T3;
[f basn ok]},
IF{M4 [f bbk override msg]("RH MISMATCH",M4)^T4;
[f basn ok]},
IF{(M1&('T1))!(M2&('T2))!(M3&('T3))!(M4&('T4)) [f basn reject];
[f basn ok]};

 

This will give an override warning if someone tries to crossmatch an Rh-neg patient with Rh-pos products. I assigned this rule to assign and issue under all of our RBC product dictionaries. I added a similar rule to the PLTs.

 

I set the override warning TYPE to Marker Mismatch/Rh Mismatch but they still show up as OTHER on the override warning report - oh well.

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