Technological Approaches for Positive Product Recipient Identification
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1 Technological Approaches for Positive Product Recipient Identification Dr.Snehil kumar, Dr.Joy J Mammen, Dr.Dolly Daniel, Amalraj P (Department of Transfusion medicine and Immunohaematology) Marshall D, Senthil sunderam P, Naveen R (Department of Information and Technology) Hani D (Department of Haematology) CHRISTIAN MEDICAL COLLEGE, VELLORE 1
2 BACKGROUND Errors or defects are an inevitable part of any process. According to the Institute of Medicine report To err is hu a Ref the u er of preventable deaths due to errors in medicine was estimated to be about 98,000 per annum. To Err Is Human: Building a Safer Health System Kohn et al National Academies Press 2
3 HAEMOVIGILANCE SHOT independent, professionally led effort by UK (1996) IHN International Haemovigilance Network (2009) HvPI Haemovigilance Program of India (2012) 3
4 Technology as a Potential Solution Information System to automate standardize control workflow in the Blood Transfusion Service Standards organization: ICCBBA Standard: ISBT128 (The Global Information Standard for Medical Products of Human Origin) Officially Endorsed by WHO and ISBT 4
5 5
6 Acronyms The acronym ISBT was originally International Society of Blood Transfusion recognition in the standard development Currently: Information Standard for Blood and Transplant The number 128 reflects the 128 characters of the ISO/IEC bit character set. ICCBBA is derived from the International Council for Commonality in Blood Banking Automation. 6
7 Process of Transfusion Process map vulnerable points 7
8 Requirements Technology Information System (CMC E-blood bank software) Barcoded wristband on patient Barcode on blood bag Access at the bedside WI-FI GSM (3G Telephony network) Platform Android 8
9 HaemTrace Making the last step safe Dedicated Android App 9
10 10
11 Framework User authentication Patient: - positive identification Machine reading preventing error Verifi atio agai st si gle sour e of truth Blood Bank Database Positive acknowledgement of verification Log/Audit trail 11
12 Current Workflow Blood Request + Sample (Labeled) manual eye readable Location: NOT necessarily bedside Sent to BB Bedside Verification PatID on Wristband vs PatID on Blood Bag Register/Process/ Crossmatch Wrist Band: Handwritten Blood Bag: Machine printed Issue to Ward 12
13 New Workflow bedside transfusion Blood Request + Sample (Labeled) manual eye readable Location: ONLY bedside Sent to BB Bedside Verification PatID on Wristband vs PatID on Blood Bag Register/Process/ Crossmatch Wrist Band: Barcoded Blood Bag: Machine printed Issue to Ward 13
14 Device ownership: BYOD /INSTITUTION owned TABLETBYOD Request to Download App via Check Name/Emp # /Active staff Link is sent on Ready to Use Download APP from CMC web Authenticated against prior data collected via /staff Self service Log In (Emp# and CWS password) First Time: Register Cell Number and IMEI SERVER 1. Master Log 2. Utilization Log PHONE 1. About 2. Log of usage from this device last 10 (get more) 14
15 Data Layer Few bytes per transaction Firewalled Secure User Telephony/ Data plan User ISP Gateway Intranet WIFI/3G GSM CMC ISP Gateway Web Services (Intranet) CMC Database 15
16 Haemtrace at Work 16
17 17
18 Monitoring: E-Blood Bank 18
19 Monitor 19
20 Monitor TO WHOM WHO WHICH WHEN PRODUCT ID COMPONENT STATUS BLOOD GROUP 20
21 Results Ongoing Pilot Tested in outpatient and inpatient setting Convenient to use Secure Audit trail Scalable solution 21
22 Problems Training Compliance Information management in the blood bank Robust communication channel 22
23 Conclusion Refocus on Transfusion safety not just Blood safety. Well developed software programmes and carefully developed SOPs to provide efficient transfusion. Real time monitoring of transfusion Centralization of transfusion services 23
24 Acknowledgement CDC-CMAI BBQMS project for funding support 24
25 Thank You 25
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