What capabilities do you need to support the key roles and major categories of analytics in blood management? First, you need to have an analytics system that will link to the major data sources that you need. That includes the blood bank and the laboratory (starting with chemistry, but it could go beyond that). Clearly, if you want to be measuring infections, you need microbiology. And then you need clinical — EMR/EHR.
Obviously, you can’t launch a program like this if you don’t have a high degree of automation. It’s just too much data, too many patients. Transfusions are widespread across surgery and medicine, so your analytics system has to have a high degree of automation.
Also, the system needs to support the fact that a program is going to be multidisciplinary, it’s going to go across clinicians, the blood bank, and the lab, so it has to enable and support a number of different users.
Finally, it has to enable a real-time type of data analysis. A retrospective look is not as useful. There has to be some capability to look at things within minutes or hours.
Blood Program Analytics Capabilities
- Link required data sources – blood, lab, clinical
- Automates analytics with minimal labor
- Supports multi-disciplinary program / users
- Delivers in real–time
Here’s an example of the analytics used in the University of Pittsburgh Medical Center’s (UPMC) program. The image to the right shows a total blood management alert. This physician got this alert because he or she wanted to give a unit of blood to someone who had a hemoglobin of 13.1. He or she is able to cancel this, of course, but this is a message saying that this is out of the guidelines.
The bubble chart below represents different physicians. It shows the number of units per patient that these physicians are transfusing, and what percentage of patients are receiving transfusions. As you can see, it’s still pretty variable. But UPMC is going to use this to identify outliers, look at patterns, and find out where they need to focus their efforts in terms of feedback.
Analytics for Preoperative Anemia Management
Preoperative anemia management is a large opportunity for impacting change. When a patient is scheduled for elective surgery, the computer could search for the most recent hemoglobin. Because patients often have their lab testing done prior to surgery, if that patient is anemic the computer would send out a preoperative anemia alert to the surgeon and the primary care physician. This is critical because by treating anemia before surgery, not only are you eliminating the transfusions that are likely to happen during surgery, but those transfusions for an anemic patient undergoing elective surgery are even more harmful than typical overuse of transfusion. There are a number of ways to treat those anemic patients, and this tactic is shown to drastically reduce adverse event rates.
The Laboratory’s Role in Blood Management
Besides analytics systems, laboratorians and pathologists can play a major role in establishing restrictive blood management programs, taking a leadership role along with others in a collaborative way to institute or expand these programs in your institution.
But analytics systems are necessary, and you need powerful ones that can link your blood bank, lab, and clinical data to successfully implement an expanded blood program. Viewics Insights for Blood ManagementTM is one solution that involves optimizing both blood bank resources and interventions of all sorts for physician utilization.
To learn more, download “Advanced Lab Analytics for Patient Blood Management Programs“.