E. Thomas Wood
In the blood bank systems marketplace of yesterday, there were two rights—right product and right patient. Today that list has doubled with the addition of right amount and right time.
“For years, the blood industry has been great at getting the right product to the right patient,” says John David Larkin Nolen, MD, PhD, MSPH, director of laboratory strategy for Cerner Corp. Obviously that issue is of paramount importance, but it’s not the only issue. “Now the focus is on using the right amount of the right product at the right time,” he explains.
“Hospitals need to ask: ‘Why does Dr. Jones always order five platelets and two plasmas and two red cells on every heart patient? He ends up not using the entire blood order.’ This reduces inventory, and if you can’t crossmatch against another patient, you end up wasting time and money,” says Dr. Nolen. “Clients are starting to ask for ways to manage that side of things.”
Adding urgency to the drive for more efficient blood product usage is the move toward bundled payments, in which providers of patient care are to be compensated—in theory—on the basis of the value they add to the clinical process.
“Money is tightening up in the lab space and the hospital space,” says Dr. Nolen. “With bundled payments on the way, everybody is looking at ways to maximize the health care dollar.”
To this end, says Randy Wambold, senior marketing manager for Haemonetics Corp., “health care organizations are looking for comprehensive, integrated solutions to further enhance safety and compliance and improve performance by capturing and analyzing data while keeping costs to a minimum.”
“Our blood center customers, for example, are increasingly looking to us to provide a solution that encompasses planning and scheduling; recruiting; donor health history; and a system of record,” Wambold explains. “We expect this trend to continue, and so we will continue to invest in integrating our blood center product portfolio.”
Haemonetics recently released an updated version of its Impact Online blood-management portal. The system “gives hospitals the tools they need to implement effective blood-management programs by enabling them to benchmark blood utilization to clinical outcomes down to patient-level details,” Wambold says. The system also offers enhanced blood utilization reporting, such as age-of-blood metrics, to measure the age of the unit of blood at the time of transfusion, as well as ABO Rh distribution reports to identify the blood type of the transfusion recipient and the blood type of the unit transfused.
Brian Forbis, director of products and business development at Blood Bank Computer Systems, says, “Blood centers are finding ways to be more competitive and have increased their focus on making strategic business decisions based on key performance indicators, such as cost, waste, and inventory levels.” The successful blood centers will incorporate these indicators into their day-to-day operations, he adds.
In July, BBCS released Pulse, a product that is integrated with the company’s Blood Bank Control System Primary Application software to create automated business dashboards. “It allows blood centers to take the extensive data that has been captured in the system and present it in easy-to-understand metrics within a Web browser,” says Forbis. “When blood centers make changes in their operations, Pulse will allow them to evaluate their improvements in relation to their key performance indicators.”
BBCS obtained FDA 510(k) clearance this year for its BloodTrack interface application, which allows blood centers to manage the remote allocation of blood units through Haemonetics’ BloodTrack remote inventory and bedside transfusion management system. A blood center can furnish units to a hospital transfusion service, and nurses can obtain those units from Haemonetics’ BloodTrack device. The BBCS system performs an electronic crossmatch against the patient’s record to ensure that the nurse is ordering the correct unit of blood, and, if everything checks out properly, the BloodTrack system will release the unit, Forbis says.
At Mediware Information Systems, the focus has been on making blood specimen, transfusion, and other data available to physicians through the patient’s electronic medical record, says John Van Blaricum, vice president of marketing and communications. “To enhance the availability of transfusion information at the bedside, we have organized focus groups that include customers, as well as EMR vendors such as Epic,” he says. “These groups discuss data and process integration needs to ensure that we make the right information available in the most appropriate ways.”
Mediware announced last month that it has purchased Strategic Healthcare Group, a provider of blood-management consulting, education, and informatics solutions. SHG’s suite of informatics tools includes the BloodStat Multidimensional Analytics database, which uses a pool of more than 8 million patient encounters to help organizations review and compare their performance results against those of similar organizations.
Megan Schmidt and Jonathon Northover, product managers at Sunquest Information Systems, told CAP TODAY that hospitals increasingly want a closed-loop approach that links positive patient identification during sample collection at the bedside and positive ID in the blood bank for allocating and issuing blood to a patient. Closing the loop, they say, requires that specimen collection and transfusion management technologies be fully integrated into a blood bank system.
Connectedness is the key word at Meditech, says Peter Manzelli, supervisor of marketing support. Blood banks increasingly are integrating analyzers with Meditech’s software, he continues. “Also, the use of bedside verification has seen an increase. All of this is a great step in regards to patient safety.”
McKesson Provider Technologies’ vice president for laboratory solutions, John Yount, sees other trends influencing the blood bank systems marketplace. The trend of hospitals merging will continue, he says, driving the need to standardize blood bank and other lab systems across these organizations for the purpose of sharing and analyzing data. Furthermore, hospitals and insurers are “moving toward a completely paperless environment.” And, he says, “with increasing guidance and rules from the American Association of Tissue Banks, AABB, and others [pertaining to] standardized tissue management, the demand for cell and tissue management systems will rise.”
Cellular therapy products are already a focus of SCC Soft Computer. The use of cellular therapy products, tracking of adverse events, and ability to support new technology, such as remote allocation of blood products, are among “the hot topics we’re seeing right now,” says SCC founder and CEO Gilbert Hakim.
SCC is developing a bi-directional interface to Haemonetics’ BloodTrack system, a project currently in the beta testing phase. Further down the line, says Hakim, SCC intends to move its SoftBank and SoftDonor blood bank and transfusion service management systems to the same platform used by the company’s Genetics Information Systems Suite, enabling it to integrate these two information systems completely.
But even as some hospitals implement increasingly sophisticated blood-management technologies, others have yet to automate at all. “Many smaller hospitals forgo computerizing their blood banks because of the ‘let’s move a mountain’ implementations that take more time and resources than the lab can muster,” says Michael Garver, applications specialist at Psyche Systems Corp. Those labs are looking for less sophisticated software solutions that help them with their workload instead of adding to it, he says. “Our goal is to provide software solutions to blood bank labs that would otherwise stick with a paper-based system.”
E. Thomas Wood is a freelance writer in Nashville, Tenn.