A standards-based application for improving platelet transfusion workflow

Objective: Thrombocytopenia is a common complication of hematopoietic stem-cell transplantation (HSCT), though many patients will become immune refractory to platelet transfusions over time. We built and evaluated an electronic health record (EHR)-integrated, standards-based application that enables blood-bank clinicians to match platelet inventory with patients using data previously not available at the point-of-care, like human leukocyte antigen (HLA) data for donors and recipients.

Materials and methods: The web-based application launches as an EHR-embedded application or as a standalone application. The application coalesces disparate data streams into a unified view, including platelet count, HLA data, demographics, and real-time inventory. We looked at application usage over time and developed a multivariable logistic regression model to compute odds ratios that a patient undergoing HSCT would have a complicated thrombocytopenia course, with several model covariates including pre-/post-application deployment.

Results: Usage of the application has been consistent since launch, with a slight dip during the first COVID wave. Our model, which included 376 patients in the final analysis, did not demonstrate a significantly decreased odds that a patient would have a complicated thrombocytopenia course after application deployment as compared to before application deployment.

Discussion: We built an EHR-integrated application to improve platelet transfusion processes. Whereas our model did not demonstrate decreased odds of a patient having a complicated thrombocytopenia course, there are other workflow and clinical benefits that will benefit from future evaluation.

Conclusion: A web-based, EHR-integrated application was built and integrated into our EHR system and is now part of the standard operating procedures of our blood bank.