(P-IT-7) Is Antibody Rule Out Software Worth It:  A Justification Evaluation

Laboratories have been focused on improving patient care by reducing turnaround times (TAT), eliminating errors, reducing direct and indirect costs. This has been challenging in transfusion services due to limited staff and expertise. For a less experienced tech performing antibody identification (ABID) is challenging, cumbersome, and intimidating due to the high level of interpretation and transcription needs. For that reason, many patient samples are sent to a reference lab (RL). This has a direct impact on TAT based on remote locations, weather, and traffic delays. We wanted to reduce ABID send out cost (SOC) while also reducing TAT by implementing an algorithmic software that included antibody rule out assistance. The focused of our study was an overall cost justification and TAT comparison.

Study

Design/Methods:

Our two hospitals perform blood bank testing with 3 Echo Lumena’s (Werfen, Norcross, GA) at 2 campuses. In 2021, we implemented a data management (DM) system, ImmuLINK 2.2 (Werfen, Norcross, GA) at both campuses. Currently, all ABID’s are performed only at one campus. Our retrospective review indicated we averaged 20 ABID samples to our RL annually, totaling $66,620 in SOC. Our cost included: RL antibody identification, phenotyping, STAT and courier (2 hour each way) fees. Depending on RL staffing and sample arrival time, the average TAT was 30-48 hours.

Currently our analyzer digitally downloads the ABID results to the appropriate master panel profile sheet, DM then uses the internal established rule out algorithm software (ROS) criteria for patient ABID, aiding the tech with those antibodies that have been excluded.

Results/Findings:

Reviewing our previous ABID send outs, it was determined that we could retain an average of 25% (5) samples ABID workups in-house annually. By utilizing the ROS for these ABID workups, we could reduce our RL send out cost by ~$16,655 per year. Based on the ROS cost, including initialization and annual subscription fee, we could still save ~$3500-$7500 annually. Plus, by performing testing in-house, we would reduce our TAT to  ~ 2 hours versus 30-48 hours (95% improvement).

Conclusions:

DM rule out algorithm software gives a preliminary antibody exclusion which assists the tech and supervisor in identifying the antibody(s). The added positive-ID, reduction of clerical errors with digital downloaded results, and assisting the tech towards a final interpretation is highly advantageous. Not all ABID may be retained inhouse but eliminating send outs by guiding the less experienced techs, plus assisting with more challenging antibodies, results in better patient care, and less stress when urgent blood products are required. In our facility we believe cost is worth the investment, especially when considering the improved TAT.