Effects of electronic decision support systems on blood usage
Project Researcher: Dr Stephen Hibbs, Academic Foundation doctor
Whilst transfusion blood products are potentially life-saving, it is crucial that they are used carefully and that accompanying risks are clearly communicated to both patients and clinicians (see Hibbs and Murphy, BMJ 2014;349:g4701).
Stephen’s work as an Academic Foundation doctor looked at the effect of electronic decision support systems (DSS) on blood usage. DSS match local guidelines to individual patient data for the purpose of providing real-time clinical recommendations. Stephen led a systematic review of their usage (manuscript in press in Transfusion Medicine Reviews) and assessed their effects locally alongside another electronic remote blood issue (see Hibbs et al., Transfusion Medicine 2014 Oct;24(5):274-9).
However, some commentators have raised concerns that efforts to question unsuitable transfusions could lead to patients having blood products withheld inappropriately. The team developed a methodology to monitor for undertransfusion and employed it across multiple sites, finding that all cases of non-transfusion in severely anaemic thrombocytopenic patients had good clinical justifications (see Hibbs et al., Transfusion 2014 Oct 21).