Hello,

Does anyone know if EPIC has a transfusion administration/positive patient ID system? Something used at the bedside to confirm that a unit of blood and a patient match up? Thanks!

It is my understanding that EPIC does not have and does not plan to develop an FDA cleared blood bank (transfusion management) system. Since the functionality you are describing would be considered an extension of the blood bank (transfusion management) system it is my understanding this functionality would require FDA clearance.

We just went live with Epic on 04/01/10. During the design phases of our system (which took place in summer 2009) the Epic team kept proudly telling me that you can "barcode your unit number into Epic and it reads ISBT". Trying to better understand the functionality of the sytem I asked, "What is the system checking the barcode against?" After much discussion and confusion surrounding my question, the answer was--nothing. The barcode functionality is simply to avoid clerical error in typing the unit number when documenting blood administration using the blood admin flowsheet. The system is not capable of an electronic verification that the unit about to be transfused was released from the transfusion service for the intended recipient.

We are just starting to "build" our Epic sytem hospital wide however the blood bank will be using SCC Soft Bank. We are planning on having a bar coded patient ID system. With it we are planning on the RNs to enter in vitals and such through this system. As I said we are just starting with Epic so we shall see if all this comes together. What system is your BB using?

We're looking for a new system now...just looking at our options, and someone in our IT dept. swore that Epic supported Transfusion Administration Verification at the bedside...I just can't find any information on it.

bduff,

While in the design phases of the system be sure to insert yourself in discussions that pertain to blood banking, including the design of the armband and even more important the blood administration flowsheet (if you plan to use it), and billing. Make sure you have a barcode readable Medical Record Number. Our site (specifically the pharmacy) wanted the CSN (an account number) barcode readable. So on our armbands the CSN is barcoded and the medical record number is only in eye readable format. As a blood banker this makes no sense to me. Since we didn't have funds for our transfusion verification software right now we let it go saying that eventually we'd need the MRN barcode readable.

We use Sunquest for our LIS, including blood bank. In all, I like Epic a lot, it's a great product and very powerful tool for us but the build and go-live (including post go-live) are very painful. I hope Epic serves us well for many years to come because I don't ever want to have to implement an HIS again.

Thank you for the info THintz. I will keep that all in mind.

We have had Epic for approximately 6 years. We are just beginning the build of the new blood administration module that came out with the Spring 08 release. We've had initial discussions with Epic on their bedside barcoding capabilities for blood administration in this module. It is my understanding that they do have the ability to match the barcoded unit number at bedside with the product that is released in the Transfusion Services LIS. However, this functionality is dependent on the LIS/Epic result interface. We will be having our first in depth technical meeting with Epic to explore the dependencies in two weeks. I'll keep you updated on what I find out.

Marisa

PS for those who want to hear my (extensive) thoughts on Epic implementation: I totally support Teri's comments about inserting yourself into the process early and developing a structure for lab to be involved in decision making in all applicable areas (although I would go one further and suggest a structure that requires outright approval/ownership by lab). This includes order entry and all it entails (order/EAP development, preference lists, order sets, order questions and defaulting answers, stop signs, best practice alerts, programming points, etc.), as well as documentation flowsheets for blood administration. But it also involves result displays, smart text resulting in physician notes/H&Ps/letters, flowsheet result interfaces and enter/edit functionality which all have issues displaying those pesky little lab items like reference ranges, abnormal flags and performing lab. Also make sure you're involved in the upgrade functionality communications, so you learn when they develop new functionality that will address your lab issues. No one will be better at understanding how the functionality can be used to enhance laboratory ordering and resulting and where it may be problematic than those individuals who have the years (and usually decades) of laboratory event management under their belt. All that being said, I think the Epic system is a wonderful tool, and wouldn't go back to the "old way of doing things". However, I keep hearing from other/new Epic users that this continues to be a very painful process for lab, which leads me to believe that Epic hasn't learned the lesson yet either.

Epic is at our hospital, starting the process. We start meeting at end of the month for laboratory and Blood Bank issues. Sounds like the next year is not going to be fun.

Thanks for sharing your information.

Cindy2008, what system are you using for blood bank?

Mysis for the Blood Bank and Sunquest for Laboratory

Can EPIC do Flow rate or rate per min?

Any bedside transfusion system must be cleared by the FDA. All cleared devices can be found at

http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/SubstantiallyEquivalent510kDeviceInformation/ucm134987.htm

The vendor should be able to give you a BK #.

Epic's blood administration module is not FDA approved, and as such, do not have a bedside transfusion administration module. The critical aspects of administration (unit #, nurse's identity, 2nd nurse's identity, amount given, time started, etc) must all be entered in either another FDA approved system, or left on paper.

We are just starting to "build" our Epic sytem hospital wide however the blood bank will be using SCC Soft Bank. We are planning on having a bar coded patient ID system. With it we are planning on the RNs to enter in vitals and such through this system. As I said we are just starting with Epic so we shall see if all this comes together. What system is your BB using?

We do not use SOFT (though the rest of the Lab does; we use HCLL) but we just had a meeting on this exact subject today. Nursing Management present at the meeting did not like the idea of entering the vitals through this system in that they would apparently still have to enter them into the Hospital system they now use. Could just be a difference in the systems we use throughout our hospital and what will and will not interface. I am not a computer expert so I will stop here before I embarrass myself.

Brenda Hutson, CLS(ASCP)SBB

We do not use SOFT (though the rest of the Lab does; we use HCLL) but we just had a meeting on this exact subject today. Nursing Management present at the meeting did not like the idea of entering the vitals through this system in that they would apparently still have to enter them into the Hospital system they now use. Could just be a difference in the systems we use throughout our hospital and what will and will not interface. I am not a computer expert so I will stop here before I embarrass myself.

Brenda Hutson, CLS(ASCP)SBB

Ok, I am replying to my own post again! The system we looked at is Medicopia (not sure if I spelled this correctly). I guess we will be a Beta site; at least for our state.

Brenda Hutson

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It seems there are getting to be several companies with stand-alone blood administration documentation software. Has anyone created a list?

These are the ones I am aware of that are FDA approved:

BD.id for Tx

Cerner

Meditech TAR

SoftID Tx

Sunquest Tx Manager

I wouldn't think Meditech's TAR would easily interface to another BBIS. Do they sell it as a stand-alone that can be interfaced to any system? The others all seem to be connected to a BBIS software brand (except I don't recognize BD.id for Tx as being software-related). Do they cross-over well?

Carefusion and CareChek are two standalone applications that are approved for blood administration.

We are in the process of installing SafeTraceTX with the hopes of having it send units information across the interface into the EPIC blood admin package tha just received FDA approval.

EPIC got FDA approval!!!! Will it work with cerner ?

You don't have to rely on "word of mouth" when it comes to Blood Establishment Computer Software (BECS) that has been cleared by FDA. There's a website you can check:

 

http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/SubstantiallyEquivalent510kDeviceInformation/ucm134987.htm

 

I do not see EPIC listed.

Without going back through all the posts in this area, we have 6 hospitals with Epic.  It, as of now, cannot discern that the unit the transfusion service assigned to the patient is indeed correct.  The nurse scans the unit number on the flow sheet.  Now that we are live with ISBT also, it will tell the nurse if the unit has been transfused to someone else already.  This is confusing because the unit number is actually a shared component with double red cells, plasma from the same WB, or platelet pheresis with multiple bags.  The E code must be scanned with each and every unit so this doesn't happen.  Epic education as prescribed by them is highly inadequate so our nurses were never taught the right way from the beginning.  They do have the option to override the system but we don't like that as an automatic fall back answer.