The following is a guest article by Jeff Dragoo, Chief Technology Officer at Digi-Trax
5 Things Inpatient IT Teams Should Know
Planned maintenance, cybersecurity incidents, network disruptions, and unexpected outages can interrupt critical healthcare workflows. Business continuity extends to protecting the blood supply network.
Whether it is an emergency or scheduled downtime, blood must keep flowing to where patients need it. Accurate, compliant blood product labeling helps to make that possible. Hospital IT teams have myriad priorities during outages. Like their clinical counterparts, they must triage. Blood bag labeling and tagging systems can keep running on their own if they are designed for stand-alone use.
A Growing Problem
System disruption is a major risk. Business continuity during IT downtime has become a foremost concern, given the increase in cyberattacks, especially ransomware. Extreme weather events, which can affect systems, are also more common. Meanwhile, healthcare demand does not let up. Women give birth. Shootings occur. Hearts fail. At worst, the crises that impact IT systems are associated with high-casualty disasters created by humans or nature.
As a result, healthcare organizations, from the point of care to industry associations, are forging emergency preparedness and contingency plans specifically for IT crises. For example, Blood Centers of America (BCA), the nation’s largest blood supply network, has digital darkness protocols for more than 60 independent community blood centers. Technology suppliers are included in these plans.
Is your organization ready? The following are five important considerations.
1. Blood Supply Visibility and Viability
Accurate labeling is crucial for patient safety in care settings where transfusions might be required. The emergency room (ER) might be the first to come to mind, but blood also must be available in labor and delivery suites, operating theaters, intensive care units (ICU), and other departments. Each bag must be compatible with the patient’s blood type. If not, there can be dire outcomes, including death.
Blood products pass through multiple handoffs before reaching the patient. A common path is from the blood collection center to a hospital blood bank or laboratory. There are many different types of blood products, each with its own standardized identification requirements. Here are five examples:
- Whole blood
- Packed red blood cells (PRBC)
- Platelets
- Fresh frozen plasma (FFP)
- Cryoprecipitate (cryo)
Every handoff in this supply chain presents an opportunity to preserve — or compromise — important data vital to patient care. Barcode-enabled workflows, standardized labeling practices, and reliable data capture help maintain efficiency, safety, compliance, and traceability throughout the process.
2. Downtime Impact
As digital darkness procedures evolve, more healthcare organizations are taking a closer look at specialized workflows, including blood labeling and identification. High-profile downtime crises, such as the CrowdStrike outage, have spurred this attention. Errors and lag time in the blood supply network can have a cascading impact on everything from surgical procedure schedules to blood supplies during a disaster.
One example is crossmatching, the final verification before a blood unit is released for transfusion. Crossmatching confirms that the patient’s blood is compatible with the donor blood unit by validating patient identification, ABO/Rh type, antibody considerations, and blood unit tracking information.
If an automated process is unavailable, clinical staff might have to manually prepare blood bag labels or tags, handwriting essential information. That can increase the potential for transcription errors, workflow delays, and inconsistent documentation during a time-sensitive process — all of which pose patient safety risks.
3. Workflow: Processes, Software, Peripherals
A successful downtime strategy has many moving parts. Automated blood labeling solutions often interface with other software, medical devices, and peripherals. This can include electronic health and medical record (EHR-EMR), laboratory information system (LIS), and blood establishment computer (BEC) solutions, labeling middleware, plus barcode label printers, scanners, and mobile devices. This connectivity is desirable for many reasons, including seamless operations and lowered risk for human error. Still, when other systems are down, you want your in-house blood supply processes to function independently, as smoothly as possible.
Clinicians must be able to maintain efficient workflows. Otherwise, they face administrative burdens and manual documentation that take time away from direct patient care. To sustain blood product workflow during downtime, there must be a fully operational labeling ecosystem that includes barcode scanners, mobile computers, label printers, and device management solutions. (See Table 1.)
By planning for the entire workflow — not just label printing — healthcare organizations can improve productivity, support staff during downtime events, and maintain continuity of operations until core systems are back online.
4. Compliance, Traceability and Auditing
Every blood unit requires accurate traceability, from origin to end use. When a blood labeling solution can operate in stand-alone mode, it helps to preserve compliant labeling procedures, documentation, and audit accountability.
The primary alternative to automated labeling is handwriting. There are four standard sections of a blood bag label, each containing crucial details about the blood product. Manually recording this information can quickly overwhelm staff, slow workflow to a crawl, and add risk for human error.
Preparedness is not just a matter of printing blood bag labels during digital darkness; it is having barcode scanning functionality. This enables efficiency and accuracy while leaving a digital trail of information that can easily be uploaded to BECS when systems are restored. Otherwise, staff are left to their handwritten notes, which they must manually enter into BECS.
5. Preparation Builds Resilience
Hospitals have made good progress in establishing digital darkness preparedness plans. As these efforts evolve, blood labeling and identification remain an important part of the conversation.
Here are some best practices for situations when cloud and wireless connections are down and system interfaces are disrupted.
Safe blood-related workflows depend on much more than technology. It takes cross-functional collaboration between IT, laboratory services, hospital and blood bank leadership, clinical operations, and vendors. This fosters better all-around knowledge of how blood bank and laboratory personnel use these technologies during both routine operations and downtime.
When downtime occurs, uninterrupted blood product handoffs, labeling, and data verification are mission-critical. With a solid plan in place, IT departments play a crucial role in blood supply safety and continuity of patient care.
About Jeff Dragoo
Jeff Dragoo is Chief Technology Officer at Digi-Trax LLC, where he has spent 18 years leading the development of labeling and identification systems for blood banks and transfusion services. He serves on ICCBBA’s Americas Technical Advisory Group (ATAG) and Cellular Therapy Coding and Labeling Advisory Group (CTCLAG), contributing to the ISBT 128 standards that govern blood and cellular therapy product identification and safety. His work bridges system engineering and patient-safety practice, with particular focus on ensuring labeling integrity when systems experience downtime or failure.
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