Blood Bank Management System

Blood Bank Management System -A Monitoring Tool For Blood Bank Standards www.cdacnoida.in 1

Amarjeet Singh Cheema, Hruday Meher & Rajiv Yadav
C-DAC/Noida

Points Covered
Overview of BBMS Existing Solutions Issue Identified Proposed Solution Conclusion Q&A

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Blood Bank Management System
Loosely coupled module of HMIS Management of blood collection and issue of blood Interacts with OPD, IPD, Patient Billing and Stores Modules www.cdacnoida.in C-DAC/Noida

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Blood Bank Modules
Camp Management Blood Inventory Investigations Blood Grouping Bag Management Donor Management OPD/IPD www.cdacnoida.in
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Enquiry
Condemnation Inventory Billing Support Services

Accounting
HR & Payroll Back Office

Core Services

Blood Bank Management System
C-DAC/Noida

Blood Bank Management
Easy Retrieval Of Donors Detail Online Blood Bag Requisition, Donor Registration Bar Coded Bag No/Sample No. Generation Easy Retrieval Of Donors Detail Effective camp management Inventory Management Extensive Reporting Capabilities Integrated With Barcode and Medical Equipments

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Major Concern of Blood Bank
Blood sustain life Blood cannot be created by any means, it can only be collected from the Humans i.e. donors A deficiency in the quality of blood will impair the quality of life and even compromise life itself No mechanism to identify Profession Donors

“Professional Donor” means a person who donates blood for a valuable consideration, in cash or kind, from any source, on behalf of the recipient-patient and includes a paid donor or a commercial donor
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Standards
NACO (National AIDS Control Organization) NABH (National Accreditation Board for Hospitals and Healthcare Providers)

“But Monitoring the Standards and Identify the Professional donors manually is a challenging job”

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Existing Solution
To cater day to day functioning of Blood Bank No mechanism to enforce the Standards Quality check are performed on selected bags Standalone Biometrics checks

Monitoring of Standards & Restriction of Professional Donors
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BBMS – A Monitoring Tool
Enforcing Mechanism – To Monitor the Standard Biometric Interfacing in BBMS – To Restrict Professional Donor

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Technical Detail
Web Based Multiple Hospital Yes Yes

Methodology
Features Standards Interfacing Architecture

Loosely Coupled using OOPS www.cdacnoida.in 11

Generic Approach, Knowledge Based All major standards Most of the Equipments N Tier, Java-J2EE

Biometrics

M2SYS BioPlugin Server - 6.6, M2SYS BioPlugIn Client - 6.6

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Enforcing Mechanism Architecture

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Standard Master

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Enforce Mechanism Example
Restrict the permanent unfit donor for further donation Printing of Bilingual Questionnaire and consent Donation can be possible after generation of bag label Physical examination details are cross checked from previous visit summary and patient EPR Transfer of stock from across fridge depends on bag status www.cdacnoida.in Expired bag cannot be issued
Bag can be issued after completion of Cross match Bag is updated in the stock only after investigation
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NACO Standards in BBMS
Point No NACO Standard A- 6.0 The blood banks and transfusion services should aim to accept blood from only voluntary non-remunerated safe blood donors and to do away with the high risk donors and blood sellers. They should gradually phase out replacement donors. (N.B.: Blood sellers have been banned as per Supreme Court directive). B-1.2 Efforts should be directed towards encouraging and retaining adequate numbers of repeat donors. Donors should be appropriately recognized and felicitated for their contribution B-3 Following guidelines should be observed in order to determine that the blood donation will not be detrimental to the donors/recipients. D-5.0 All mandatory tests should be carried out on blood samples in pilot tubes taken at the time of collection. The whole blood or components from any unit that tests positive should be 15 C-DAC/Noida discarded.

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Professional Donor Restriction
Database Level Searching www.cdacnoida.in 16

Biometric Integration

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Professional Donor Restriction

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Biometric Search
DONOR

Blood Bank Rule

Finger Print Scanner Search Save Data Base Donor Bio Metric deatils No Bio Metric Info Yes No

Another finger

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Bio Metric Info

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Professional Donor Restriction
Bio Metric Info Search

Data Base Is Donor Details Yes Donor Info with last visit deatils Yes Unstamped Donor No Is Donor Eligible Yes Stamped Donor Data Base Is Donor Details Data Base No No Demographic Details

Save Bio Metric & Demographic Details

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Professional Donor Restriction

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Assumptions
All NACO Guidelines should be part of master setup

Uses of BBMS should be in all areas of Blood Bank
Centralized Donor Repository - for the Restriction of Professional Donors across Blood Bank www.cdacnoida.in C-DAC/Noida

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Blood Bank Management
Follow NABH & NACO Guidelines Restriction of Professional donors Integration with EPR for clinical details of the patients for physical examinations Extensive Reporting Comprehensive User Management – Roles & Rule Integrated With Barcode, Biometrics and Medical Equipments

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Conclusion
Blood Bank Management System ensures strict adherence to NACO Standards and also prevent the professional donors in the Blood Bank. It ensures that, as far as possible staff adheres to the guidelines for doing their routine activities.

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Statistics @ SMSH
Period Without Biometric With Biometric

1840

6451

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01-Jan-2010 To 31-Dec-2010 01-Jan-2011 To 20-Mar-2011

23457

4146

News Paper Article

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What Next?....
Despite the various issues which need to be addressed …
RFID Based Transfusion RFID Temperature Tag

A long road ahead
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C-DAC/Noida

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Experience in Blood Bank
SGPGI Lucknow - Since 1998 GTBH Delhi - Since 2000 Northern Railway Central Hospital, New Delhi - Since 2002 GB Pant, Port Blair – Since July 2004

General Hospital, Chandigarh, Since Jan 2005
MGIMS, Sevagram (Wardha), Since Jan 2005 Regional Institute of Medical Sciences, Imphal – Since Jan 2006 Indira Gandhi Medical College, Shimla SMS Hospital Jaipur Government of NCT of Delhi PGIMER Chandigarh – Under Implementation
C-DAC/Noida

Arogya Online, Rajasth

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Generation of BBMS
Technically Blood Bank functionality & Issue Resolutions www.cdacnoida.in C-DAC/Noida

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Generations of Blood Bank Issues
Stage 0
Issues  There is no centralized Information and Knowledge Management  There is no centralized Rights and user authentication  The information is written in the registers  Stock is maintained and checked daily by a person and updated in the registers.  Getting details of a particular Donor or Blood is not easy.  There is no facility to get instant information about the availability of blood or the status of the blood bag.  There is no any efficient facility to track the blood that will be expired soon.  There is no facility of generate different types of reports regarding blood or the donors  There is very less quality testing process conducted.  Monitoring of Standards depends on the user

Stage 1

Stage 2

Stage 3

Features  Automated All Process  Donor & Bag information is easily available  Inventory management

Features Features  All points of stage 1  All Points of stage 1  Identification of &2 professional donor  Quality Checks are using bio metric scheduled through  Integration with Auto the system. analyzer  Enforcing the standards  Dynamic Issues Issues Guidelines &  There is very less quality  There is very less Checklist as per testing process quality testing Standards conducted. process conducted.  Monitoring of Standards  Monitoring of depends on the user Standards depends on  No mechanism to detect the user Professional Donor  Guidelines &  No integration Checklist  Guidelines & Checklist

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Generations of BBMS :Technically
Components 1st Generation (HIS) No No Yes No 2nd Generation (HMIS) Yes Yes 3rd Generation (AHMIS) Web Based Multiple Hospital/ Centralized Database Methodology

Tightly Coupled

Loosely Coupled

Loosely Coupled using OOPS

Features

Cover Module Centric Work Flow Nil

Web Based Application & Hospital Centric Approach ICD 10

Generic Approach, Knowledge Based, Business Reengineering All major standards

Standards

Interfacing

Nil

Only in Investigation

Most of the Equipments

C-DAC/Noida

Architecture & Technologies

2 & 3 Tier, Core Java, C Proc, D2K

N Tie Java-J2EE

N Tie Java-J2EE

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NACO Standards in BBMS
Point No A- 6.0
NACO NACO Standard The blood banks and transfusion services should aim to accept blood from only voluntary nonremunerated safe blood donors and to do away with the high risk donors and blood sellers. They should gradually phase out replacement donors. (N.B.: Blood sellers have been banned as per Supreme Court directive). Efforts should be directed towards encouraging and retaining adequate numbers of repeat donors. Donors should be appropriately recognized and felicitated for their contribution Following guidelines should be observed in order to determine that the blood donation will not be detrimental to the donors/recipients. BBMS   Identification of professional donor using bio metric Automatic identification of already registered donor and getting the clinical information from EPR Auto generation of mail as per the schedule

B-1.2

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B-3

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Dynamic examination & questionnaire tile as per NACO guidelines based on donor type, donation type and donor gender Configurable blocking Days according to gender, last donation type and donation component In case if donor is also a patient in hospital then system will automatically check clinical guidelines from EPR. Donation can only captured after the generation of bag labels and mapping of bag tubing no.

C-6.0

C-DAC/Noida

The blood samples in the pilot tubes (clotted and  anticoagulated) should be collected at the time of collection of blood by the same person who collects blood. They should be marked before collection to be identified with the unit of blood…

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NACO Standards in BBMS Point No D-5.0 NACO NACO Standard All mandatory tests should be carried out on blood  samples in pilot tubes taken at the time of collection. The whole blood or components from any unit that tests positive should be discarded. A system should be in place to ensure that final  container is labeled only after all mandatory testing is completed as per pharmacopoeal requirements. STORAGE AND EXPIRATION  BBMS

After performing TTI Screening and if report is reactive then the blood cannot be used and is stored in a different storage for discard
Final label is printed only after the grouping, separation of components and completion of all the mandatory tests. The expiry of blood component is automatically calculated by the system depending on the closed/open system.

F-1.0

H-3.0

K-1.0

Blood should be issued from the blood bank along  with the blood cross matching report form. A portion of the integral tube with at least one numbered segment should remain attached with the blood bag being issued. It is recommended that blood once issued should  not be taken back by the Blood Bank, especially if the cold chain is broken. INFORMED CONSENT  Bio safety and Waste Disposal 

At the time of issue of blood the system will generate a cross match report and that report is attached with the issued bag.

K-4.1

Any blood bag returned by the patient is kept in a different storage area for discard.

L-1.0
Q

System generated consent is taken from the patient.
Dynamic guidelines disposal of waste. and checklist for

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Professional Donor Identification
As per the Blood Bank rules, donor will ask to put the finger on Biometric device System will search the finger impression in database If impression found then system returns the donor information with last visit details If donor eligible then only system will allow to stamp donor visit If biometrics fail to find the donor information then we can check for other fingers as per blood bank rules If no information found then we also have the second level check i.e. system check the existing donor in database on the basis of information keyed such as donor name, age, father name, address etc If donor is not an existing donor then in that case system will treat the donor as new donor and save the information and finger impression into database
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News Paper Article

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Functional Overview
Security Front Office (Registration, Admission, Patient Information) OPD

MIS
Back Office(Accounting & Payroll)

Room Mgt.

OT Hospital Diagnostics

Medical Records

Nursing
Blood Bank Mgt. Stores
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Housekeeping
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Application
Firewall
Client

Architecture

EJB
Client
Client Client

HMIS JSP/ Servlet EJB

Client
Other Services:

JNDI, JMS, JavaMail, XML

Client Tier
C-DAC/Noida

Middle Tier

HMIS Tier
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JSP/ Servlet

Application Server

Features And Functionality
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Fast and reliable Information Instant Information for research and library classification. Routes workflow, documents and information electronically Customized clinical data according to each department and laboratory Comprehensive User Security & Alert Management Greater and effective control on accounts and resources Improves resource utility Bridges information gap across the hospital Integrated With C-DAC- PACS and Telemedicine www.cdacnoida.in Flexibility and Integration abilities assist in managing change

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Interfaces
Bar Code Interface  Biometrics  SMS Server  Smart Card  Digital Tablet  Medical Equipment Interface Auto Analyzer  Coulter  MRI CT Scan Machine etc
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Standards
ICD 10  DICOM  NACO & NABH Standard for Blood Bank  HL-7
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Experience in Blood Bank
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SGPGI Lucknow (1998) GTBH Delhi (2000) Central Hospital, Northern Railway, New Delhi (2002) GB Pant, Port Blair (2004) General Hospital, Chandigarh (2005) MGIMS, Sevagram (Wardha) (2005) www.cdacnoida.in
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Regional Institute of Medical Sciences, Imphal (2006)
Indira Gandhi Medical College, Shimla (2006) SMS Hospital Jaipur (2010) Government of NCT of Delhi PGIMER Chandigarh – Under Implementation Arogya Online, Rajasthan – Under Development

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 C-DAC/Noida

Issue Identified
Monitoring of Standards Restriction of Professional Donors www.cdacnoida.in C-DAC/Noida

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