Blood Bank Proposal
Blood Bank Proposal
Blood Bank Proposal
The remaining sections of the proposal include the detail descriptions of the messages, segments and
message usage.
OMB OMB
ORB ORB
Blood Product Dispense Status Message - Blood Product Ready to Dispense (RD) from filler
(Trigger Event O28)
BPD
Acknowledgement by placer
(Trigger Event O29)
BRP
BPD
Acknowledgement by placer
(Trigger Event O29)
BRP
Stop/Cancel Transfusion
(Trigger Event O32)
BTS
Acknowledgement by filler
(Trigger Event O33)
BRT
BTS
Acknowledgement by filler
(Trigger Event O31)
BRT
Blood product orders can use the OMB message with the BPO segment for the detail segment and
the acknowledgment message, ORB as described below.
OMB^O26^OMB_O26 Blood Product Order Message Chapter
MSH Message Header 2
[{NTE}] Notes and Comments (for Header) 2
[
PID Patient Identification 3
[PD1] Additional Demographics 3
[{NTE}] Notes and Comments (for Patient ID) 2
[PV1 Patient Visit 3
[PV2]] Patient Visit - Additional Info 3
[{IN1 Insurance 6
[IN2] Insurance Additional Info 6
[IN3] Insurance Addl Info - Cert. 6
}]
[GT1] Guarantor 6
[{AL1}] Allergy Information 3
]
{
ORC Common Order 4
[
BPO Blood Product Order 4
[{NTE}] Notes and Comments (for BPO) 2
[{DG1}] Diagnosis 6
[{
OBX Observation/Result 7
[{NTE}] Notes and Comments (for OBX) 2
}]
[{FT1}] Financial Transaction 6
[BLG] Billing Segment 6
]
}
A new message type and trigger event are proposed to initiate the transmission of a blood product
dispense status message each time the status of a blood product changes.
Blood product dispense status messages will use the BPS and BRP messages as described below.
BPS^O28^BPS_O28 Blood Product dispense status Message Chapter
MSH Message Header 2
[{NTE}] Notes and Comments (for Header) 2
[
PID Patient Identification 3
[PD1] Additional Demographics 3
[{NTE}] Notes and Comments (for Patient ID) 2
[PV1 Patient Visit 3
[PV2]] Patient Visit - Additional Info 3
]
{
ORC Common Order 4
Blood product transfusion messages will use the BTS and BRT messages as described below.
BTS^O30^BTS_O30 Blood Product Transfusion Message Chapter
MSH Message Header 2
[{NTE}] Notes and Comments (for Header) 2
[
PID Patient Identification 3
[PD1] Additional Demographics 3
[{NTE}] Notes and Comments (for Patient ID) 2
[PV1 Patient Visit 3
[PV2]] Patient Visit - Additional Info 3
]
{
ORC Common Order 4
{
BPO Blood Product Order 4
[{NTE}] Notes and Comments (for BPO) 2
[{
BTX Blood Product Transfusion Status/Observation 4
[{NTE}] Notes and Comments (for BTX) 2
}]
}
}
If details are needed for a particular type of order segment (e.g., Pharmacy, Dietary), the ORC
must precede any order detail segment (e.g., RXO, ODS). In some cases, the ORC may be as
simple as the string ORC|OK|<placer order number>|<filler order number>|
<cr>.
If details are not needed for the order, the order detail segment may be omitted. For example, to
place an order on hold, one would transmit an ORC with the following fields completed: ORC-1-
order control with a value of HD, ORC-2-placer order number, and ORC-3-filler order number.
The following table was used to present various use cases surrounding blood product orders.
Discussions of these examples led to the identification of new fields needed that are required for
blood product order messages.
As can be seen from this table, in addition to the Universal Service ID, it may be necessary to
order special blood product attributes, such as leukoreduced or irradiated, or it may be necessary a
particular volume of red blood cells required for transfusion. The attributes for the BPO Segment
are defined below.
1 4 SI R Set ID BPO
2 250 CE R BP Universal Service ID
3 250 CE O Y BP Attributes
4 5 NM O BP Amount
5 250 CE O BP Units
6 26 TS O BP Intended Use Date/Time
7 80 PL O BP Intended Dispense From Location
8 26 TS O BP Requested Dispense Date/Time
9 80 PL O BP Requested Dispense To Location
10 250 CE O BP Indication for Use
11 1 ID O BP Informed Consent Indicator
Definition: This field contains the sequence number for the BPO segment within the message. For
the first order transmitted, the sequence number shall be 1; for the second order, it shall be 2; and
so on.
Definition: This field contains the identifier code for the requested observation/test/battery. This
can be based on local and/or universal codes. We recommend the universal procedure
identifier. The structure of this CE data type is described in the control section. The preferred
coding system is the ISBT 128 Product Cod e.
Blood Product Orders for commercial products such as Rh Immune Globulin or Factor VII
concentrate are not defined in an international or national coding system as are blood product.
Therefore, locally defined codes can be used of the Universal Service Identifier for commercial
products.
Definition: This field contains additional information about the blood component class associated
with the Universal Service ID. The placer of the order can specify any required product attributes
or special processing requirements for the blood product, which must be completed prior to
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12
transfusion to the intended recipient. Examples of processing requirements or product attributes
include CMV Negative, HLA Matched, Irradiated or Leukoreduced. Refer to HL7 Table #### (to
be assigned) - Blood Component Transfusion Requirements for suggested values.
LR Leukoreduced
IR Irradiated
CS CMV Safe
FR Fresh unit
AU Autologous Unit
DI Directed Unit
HL HLA Matched
CM CMV Negative
HB Hemoglobin S Negative
WA Washed
IG IgA Deficient
Definition: This field contains the ordered amount (volume) associated with each quantity of
blood product.
This field is optional so that a unit of blood can be ordered without an amount or unit specified.
Definition: This field contains the units for the blood product amount. This field contains the
designation for unit of measure for blood products. See 7.15.3.3.2.
This field is optional so that a unit of blood can be ordered without an amount or unit of measure
specified.
Definition: This field specifies the date/time associated with the scheduled availability of the
blood product.
This is the time when the product is expected to be available within the transfusion service. For
example, the product should be available for use but not dispensed on this date/time. This field is
optional.
Definition: The first component contains location from which the blood component is to be issued
(if applicable). Locally defined codes can be used for this field. This field is an optional field and
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is used when the transfusion service has more than one site from which blood products can be
dispensed. This location would indicate the specific facility from which the blood product should
be dispensed.
Definition: This field specifies the date/time that the requested blood products must be ready to
dispense. This date/time may be different from the Intended Use Date/time. For example, the
patient may be scheduled to come in for a transfusion at a specified time. However, the placer
would request that the blood product be ready to dispense prior to that in order to have the blood
component ready for transfusion at the scheduled time.
Subcomponents of facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type
(ID)
Definition: The first component contains the inpatient or outpatient location to which the blood
component is to be dispensed. The default (null) value is the current census location for the
patient. Site-specific table. The first eight components have the same form as the first eight
components of PV1-3-assigned patient location. The final eight components replace the ninth
component of PV1-3-assigned patient location and represent the full address specification.
This is a coded optional field. The value indicates the reason that the blood product was ordered.
Locally defined codes can be used for this value. This information is helpful for prospective
review or retrospective studies of blood product ordering practices of the ordering provider by the
Quality Assurance Department and/ or Transfusion Committee.
This field indicates whether consent for the transfusion has been obtained.
A new message type and trigger event is proposed to initiate the transmission of a blood product
dispense status message each time the blood product dispense status changes.
1 4 SI R Set ID BPX
2 250 CE R BP Status
3 1 ID R BP Observation Status
4 26 TS R BP Date/Time of Status
5 15 ST C BP Donation ID +
6 250 CE C BP Component +
7 250 CE C BP Donation Type / Intended Use +
8 250 CE C BP Commercial Product *
9 250 XON C BP Manufacturer *
10 22 EI C BP Lot Number *
11 250 CE O BP Blood Group +
12 250 CE C Y BP Special Testing +
13 26 TS O BP Expiration Date/Time
14 5 NM R BP Quantity
15 5 NM O BP Amount
16 250 CE O BP Units
17 22 EI O BP Unique ID
18 80 PL O BP Actual Dispense To Location
19 250 CE O BP Dispensed to Receiver
20 250 XCN O BP Responsible Observer
21 22 EI O BP Equipment Instance Identifier
The daggered (+) items in this segment are specific for blood component transactions, such as red
blood cells, fresh frozen plasma and platelets.
The starred (*) items in this segment are relevant only for commercial blood product transactions.,
such as Factor Concentrate and Rh Immune Globulin.
Definition: This field contains the sequence number for the BPX segment under the related BPO
segment. For the first blood product dispense status transmitted, the sequence number shall be 1;
for the second product dispense status, it shall be 2; and so on.
Definition: This field is used to indicate the current status of the specified blood product as
indicated by the filler. For example, the first status change of a product that may trigger a Blood
Product dispense status Message is when it first becomes linked to a patient and is ready to
dispense to a patient. When the blood product is delivered or issued to a patient, the status of the
blood product would be changed to indicate that it has now been dispensed. A final status
would indicate that the product has actually been transfused. Refer to HL7 Table #### (to be
assigned) - Blood Product dispense status for suggested values.
Definition: The most commonly used values in a BPX will be preliminary and final. A status is
considered preliminary until a blood product has reached a final disposition for the patient. For
example, when the product is first cross-matched and a status message is sent, it would be
considered preliminary. When the product is dispensed to the patient, that status would also be
considered preliminary. However, once the product is transfused, the status would be considered
final. The status of a blood product can continue to change and the previous result should be
overwritten until it reaches a final status.
Definition: This field indicates the date and time that the status of the blood component was
changed. For example, if the blood component had a status, of "RD" (Ready to Dispense) , the
date and time in this field would indicate the date and time that component was made ready to
dispense by the filler system. This is a required field.
Definition: The donation ID is the unique identification number assigned to a blood donation. The
donation number will depend upon the bar code labeling system used for the component. There
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are currently two blood component labeling standards: ABC CODABAR and ISBT 128. If using
ISBT 128, the donation ID Number is an internationally unique identifier consisting of the
following 13 characters:
Country Code
Collection Facility
Donation Year
Serial Number
This is a conditional field and is required for blood components. It is not applicable for
commercial product messages.
Definition: The Blood Component field includes a description of the specific blood component.
1st component: The numeric or alphanumeric product code, which represents the type of blood
component. The coding system will be determined by the bar code labeling system on the
particular component of blood. The preferred coding system is ISBT 128. If using ISBT 128
labeling standard, the product code will consist of an 8-character alphanumeric code, starting with
an alpha character and will include the component class, donation type/intended use and division
indicator.
If using CODABAR product labeling standard, the product code will consist of a 5-character
numeric.
2nd Component: Product Description: The Product Description is a textual description of the
numeric or alpha numeric product code.
This is a conditional field and is required for blood components. It is not applicable for
commercial product messages.
Definition: Donation Type is used to indicate the type of donation or collection/intended use. This
value is populated from the list of Reference values below. The default value is 0 or
Unspecified. Other values will indicate if the blood product is an allogeneic unit from a
volunteer donor, or is intended for a specific recipient but may be crossed over and used for
another recipient, or is an autologous donation intended only for that particular recipient. Refer to
Table 5 -Type of Donation in the ISBT 128 Bar Code Symbology and Application Specification
for Labeling of Whole Blood and Blood Components
Value Description
0 Not specified
1 For autologous use only
X For autologous use only biohazardous
V Voluntary allogeneic
D Directed voluntary donation eligible for crossover
Small d Directed paid donation eligible for crossover
This is a conditional field and is optional for blood component messages. It is not applicable for
non-commercial product messages.
Definition: This field contains the code and description to identify a commercial product.
Examples of commercial products are blood derivatives such as Rh Immune Globulin and Factor
VIII concentrate, Leukoreduction filters, and blood administration sets.
A site-specific table determines the value of the Commercial Product field. Free text can be
utilized if no update is to occur.
This is a conditional field and is required for commercial blood products. It is optional for blood
component messages.
Definition: This field identifies the manufacturer of the commercial product. The manufacturer
may not be the same as the supplier of the commercial product.
This is a conditional field and is required for commercial blood products. It is not applicable for
blood component messages.
Definition: This field identifies the lot number for blood derivatives or commercially supplied
items used as accessories to transfusion.
This is a conditional field and is required for commercial blood products. It is not applicable for
blood component messages.
This is a conditional field and is required for blood components. It is not applicable for
commercial product messages.
Definition: This is a repeating optional field to allow multiple entries for special testing that was
performed. The Special Testing code is used to indicate any types of Special Testing performed on
the blood component. The preferred coding system for Special Testing is defined in the ISBT 128
Bar Code Symbology and Application Specification. Proposals have been developed and will soon
be published by ICCBBA, Inc. for the encodation of other antigen and antibody specificities
including, HLA, platelet, red cell and other types of markers.
This is a conditional field and is optional for blood component messages. It is not applicable for
non-commercial product messages.
Refer to Table Table I3 Special Testing Codes of the ISBT 128 Bar Code Symbology and
Application Specification,
N0000 default
N0001 HLA phenotyped
N0002 HPA phenotyped
Definition: The expiration date/time specifies the date and time that the blood product expires.
The blood product is no longer considered acceptable once the expiration date has been reached
unless cleared by the blood bank medical staff.
Definition: This field indicates the number of blood bank products or components.
Definition: This field contains the ordered amount (volume) associated with each quantity of a
blood bank component. This is an optional field.
Definition: This field contains the units for the blood product quantity. (See Chapter 7 for more
details about identifying reporting units.) This field may be used to specify the units of measure
for volume of a blood component (i.e. 50 ml). It may also be used to indicate the unit of measure
or dosage of a commercial product (i.e. 910 I.U. - International Units - of Factor VIII
Concentrate).
Definition: This field is a unique system-generated number assigned to the blood product to
which the message is referring. Each time the status is updated, the new message should replace
the previous message if the Blood Product dispense status ID Number is the same. If the Blood
Product dispense status ID Number is different, it indicates that the status applies to a different
blood product.
This is an optional field and its use must be agreed upon by the sending and receiving systems.
Subcomponents of facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type
(ID)
Definition: The first component contains the inpatient or outpatient location to which the blood
component was actually dispensed. The default (null) value is the current census location for the
patient. Site-specific table. The first eight components have the same form as the first eight
components of PV1-3-assigned patient location. The final eight components replace the ninth
component of PV1-3-assigned patient location and represent the full address specification
This field is optional.
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4.4.3.19 BPX-19 BP Dispensed to receiver (CE)
Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate
identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system
(IS)>
Definition: This is the person who picked up the blood unit(s) and transported them. The code for
the receiver is recorded as a CE data type. If the code is sent as a local code, it should be unique
and unambiguous when combined with BPX-250-producer ID. This field can be free-text to
permit capture without table update. In this case, the receiver must be recorded as the second
component of the field.
Definition: This field is used to indicate the identification of the individual who prepared the
blood component. The values for this field would reference a site-specific table of employees.
This is an optional field.
Definition: This field identifies the Equipment Instance (e.g., Analyzer, Analyzer module, group
of Analyzers) responsible for the production of the observation. This is the identifier from an
institution's master list of equipment, where the institution is specified by the namespace ID or if it
is blank, then by the BP Producers ID (BPX-7). It should be possible to retrieve from this
master list the equipment type, serial number, etc., however it is not planned to transfer this
information with every BPX. The repeating of this field allows for the hierarchical representation
of the equipment (lowest level first), e.g., module of an instrument, instrument consisting of
modules, cluster of multiple instruments, etc.
1 4 SI R Set ID BTX
2 15 ST C BT Donation ID +
3 250 CE C BT Component +
4 250 CE C BT Blood Group +
5 250 CE C BT Commercial Product *
The daggered (+) items in this segment are specific for blood component transactions, such as red
blood cells, fresh frozen plasma and platelets.
The starred (*) items in this segment are relevant only for commercial blood product transactions.,
such as Factor Concentrate and Rh Immune Globulin.
Definition: This field contains the sequence number for the BTX segment under the related BPO
segment. For the first product dispense status transmitted, the sequence number shall be 1; for the
second product dispense status, it shall be 2; and so on.
Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate
Definition: The donation ID is the unique identification number assigned to a blood donation. The
donation number will depend upon the bar code labeling system used for the component. There
are currently two blood component labeling standards: ABC CODABAR and ISBT 128. If using
ISBT 128, the donation ID Number is an internationally unique identifier consisting of the
following 13 characters:
Country Code
Collection Facility
Donation Year
Serial Number
This is a conditional field and is required for blood components. It is not applicable for
commercial product messages.
1st component: The numeric or alphanumeric product code, which represents the type of blood
component. The coding system will be determined by the bar code labeling system on the
particular component of blood. The preferred coding system is ISBT 128. If using ISBT 128
labeling standard, the product code will consist of an 8-character alphanumeric code, starting with
an alpha character and will include the component class, donation type/intended use and division
indicator.
If using CODABAR product labeling standard, the product code will consist of a 5-character
numeric.
2nd Component: Product Description: The Product Description is a textual description of the
numeric or alpha numeric product code.
This is a conditional field and is required for blood components. It is not applicable for
commercial product messages.
Definition: This field indicates the blood group of the blood component. The preferred values for
the blood group are the ISBT 128 specified values in Table 3A Encodation of Blood Group in the
ISBT 128 Bar Code Symbology and Application n Specification.
This is a conditional field and is required for blood components. It is not applicable for
commercial product messages.
95 O Rh negative
51 O Rh positive
06 A Rh negative
62 A Rh positive
17 B Rh negative
73 B Rh Positive
28 AB Rh negative
84 AB Rh positive
55 O
66 A
77 B
88 AB
D6 para-Bombay Rh negative
E6 para-Bombay Rh positive
G6 Bombay Rh negative
H6 Bombay Rh positive
Definition: This field contains the code and description to identify a commercial product.
Examples of commercial products are blood derivatives, such as Rh Immune Globulin and Factor
VIII Concentrate and transfusion accessories, such as Leukoreduction filters, and blood
administration sets.
This is a conditional field and is required for commercial blood products. It is optional for blood
component messages.
Definition: This field identifies the manufacturer of the commercial product. The manufacturer
may not be the same as the supplier of the commercial product.
This is a conditional field and is required for commercial blood products. It is not applicable for
blood component messages.
Definition: This field identifies the lot number for blood derivatives or commercially supplied
items used as accessories to transfusion.
This is a conditional field and is required for commercial blood products. It is not applicable for
blood component messages.
Definition: This field indicates the number of blood bank products or components.
Definition: This field contains the ordered amount (volume) associated with each quantity of a
blood bank component. This is an optional field.
Definition: This field contains the units for the blood product quantity. (See Chapter 7 for more
details about identifying reporting units.) This field may be used to specify the units of measure
for volume of a blood component (i.e. 50 ml). It may also be used to indicate the unit of measure
or dosage of a commercial product (i.e. 910 I.U. - International Units - of Factor VIII Concentrate.
Definition: This field is used to indicate the current status of the specified blood product as
indicated by the placer. For example, the placer may return the blood product to the transfusion
service unused or wasted because an IV could not be started. A final status would indicate that
Definition: The most commonly used values in a BTX will be preliminary and final. A status is
considered preliminary until a blood product has reached a final disposition for the patient. For
example, when the product is first cross-matched and a status message is sent, it would be
considered preliminary. When the product is dispensed to the patient, that status would also be
considered preliminary. However, once the product is transfused, the status would be considered
final. The status of a blood product can continue to change and the previous result should be
overwritten until it reaches a final status.
Definition: This field indicates the date and time that the status of the blood component was
changed. For example, if the blood component had a status, of "TX" (Transfused), the date and
time in this field would indicate the date and time that component was transfused the placer
system.
Definition: This field contains the identity of the individual who assists in the identification of the
patient and verification of the product information prior to transfusion of the blood product. The
code for the verifier is recorded as a CE data type. If the code is sent as a local code, it should be
unique and unambiguous when combined with BPX-250-producer ID. This field can be free-text
to permit capture without table update. In this case, the verifier must be recorded as the second
component of the field.
Definition: This field indicates the date and time that the verifier started the transfusion of the
blood component or commercial product.
Definition: This field indicates the date and time that the transfusion of the blood component or
commercial product was completed or stopped.
This field indicates whether the recipient of the blood product experienced an adverse reaction.
Definition: This field contains the type of adverse reaction that the recipient of the blood product
experienced. Locally defined codes for this value can be used. This is an optional field.
This field indicates whether the transfusion of the blood product experienced was interrupted or
stopped prior to the completion of the transfusion.
Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate
identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system
(IS)>
Definition: This field contains the type of adverse reaction that the recipient of the blood product
experienced. Local codes for this value can be used. This is an optional field.
Definition: This field contains the reason that the transfusion of the blood product was interrupted.
Locally defined codes for this value can be used. This is an optional field.