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Transfusion Service

(P-TS-115) Utilization of Electronic Health Information Exchange to Honor Otherwise Unknown Patient Red Blood Cell Antibody History 

Sunday, October 20, 2024
12:00 PM - 1:00 PM  
Background/Case Studies: In transfusion medicine, a patient's history plays a vital role in identifying challenging red blood cell (RBC) antibodies, resolving inconsistencies within testing, and ensuring the provision of safe blood to patients. Many patients are treated at multiple facilities; maintaining comprehensive patient records can pose a significant challenge. Electronic Health Information Exchange (HIE) enables institutions to share electronic Protected Health Information (PHI) for treatment purposes. It allows data sharing among institutions that have the electronic HIE feature (and patient consent), providing more comprehensive patient history. This retrospective chart review evaluates clinical utility of one vendor’s HIE related to RBC antibody history.

Study

Design/Methods: Retrospective chart review was completed over a one year period for patients without prior RBC antibody history at the current facility but with history of antibodies via the EHR’s HIE feature.

Results/Findings: A total of 34 patients without history at one institution had RBC antibody histories in the EHR HIE. When tested at the current facility, 24 (71%) of patients had negative antibody screen results and 10 (29%) had positive antibody screens. Of the 10 patients with positive antibody screens, 6 (60%) of those were found to have additional antibodies compared to the history found in the EHR HIE. Of the 24 patients with a negative antibody screen when tested at the current hospital, 15 (63%) of those patients had a history of clinically significant antibodies in EHR HIE. In total, 10 of the 34 patients (29%) required blood transfusions at the current hospital. 6 of the10 patients (60%) who received blood transfusions had negative antibody screens at the time of testing but were provided with antigen negative blood to honor the clinically significant antibody histories found in the EHR HIE.

Conclusions: This retrospective chart review demonstrates that accessing a comprehensive patient history from various institutions using an HIE feature enables transfusion medicine services to offer patients safe, antigen-negative blood, thereby minimizing potential transfusion complications. Availability of patient RBC antibody history aids in prevention of hemolytic transfusion reactions for patients with historic clinically significant antibodies that would otherwise have been missed due to antibody evanescence or rarity. Availability of EHR HIE RBC antibody histories also contribute to the effective allocation of resources by facilitating appropriate testing without causing unnecessary delays in antibody identification.