Transfusion Medicine - Administration

Transfusion Medicine - Administration (TMA) defines workflows and messaging transactions which focus on communicating the administration of and adverse reactions to blood products from an Electronic Medical Record (EMR) system to a Laboratory Information System (LIS), Incident Reporting System (IRS), or other interested observer of the transfusion process.

Summary

The primary function of the full clinical transfusion medicine workflow is to ensure the appropriate matching & release of compatible blood products from an institutional supply to an individual patient recipient. Although there are shared elements with medical oncology/chemotherapy and genomic-based medicine, this particular function and the individualized precision it requires is largely unique within the current field of medicine aside from the closely related discipline of solid organ transplantation.
The Transfusion Medicine – Administration (TMA) supplement defines workflows and messaging transactions which focus on communicating the administration of and adverse reactions to blood products from an Electronic Medical Record (EMR) system to a Laboratory Information System (LIS), Incident Reporting System (IRS), or other interested observer of the transfusion process. These additions update the Technical Framework volumes 1 and 2.
Prior parts of the full clinical transfusion medicine workflow including patient testing and product ordering, as well as subsequent product dispensing and internal inventory/tracking, will be detailed in additional supplements. These are provisionally expected to be Transfusion Medicine – Ordering (TMO) and Transfusion Medicine – Dispense (TMD).

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Benefits

Reduces Errors and Enhances Patient Care

• Prevents manual data entry errors by ensuring that each piece of information is entered only once, by the person closest to the source of this information, and from there, made available in due time to any system who needs it.

Details

The Transfusion Medicine - Administration (TMA) Integration Profile provides specifications for clearly communicating the status and outcomes of workflows pertaining to administration of prepared blood products to a patient.
The TMA Profile represents the third and final portion of the full clinical transfusion medicine workflow. The first and second portions are ordering & testing, and product dispensing with inventory tracking. These prior workflow elements will be described in other profiles and together the three profiles will specify the full integration needs from the recipient’s perspective in transfusion medicine.

Use cases:
TMA Profile use cases assume that the appropriate prepared blood products have already been ordered, issued & dispensed, and are ready at the point of care.

• Single Administration
• Single Administration with interruption
• Single Administration with Reaction

Transactions:
TMA Integration Profile defines 1 Transaction1, based on HL7 release 2.5.1 messaging standard. This transaction selects a subset of HL7 message structures (based on BTS) and specifies a set of constraints applying to each message structure, as well as the responsibilities of the sender and receiver.

This profile leverages IT Infrastructure profiles [PAM] or [PDQ] for up to date patient and encounter data, and IT Infrastructure profiles [ATNA] and [CT] for security.

Units of work:
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Systems Affected

Systems involved in this profile are:

• One or more Clinical Information Systems (CIS) or Electronic Medical Record (EMR) systems. Each of these systems is operated by a clinical facility and provides a number of features such as order entry, order placing, placer order management and follow-up, order result tracking, management of patient biologic history, specimen calculation, specimen identification... A CIS/EMR usually implements the Actors Order Placer and Order Result Tracker for the profile LTW. In this TMA profile, the CIS/EMR can act as Blood Transfusion Documenter

• One or more Laboratory Information Systems (LIS). Each of these systems is operated by a number of clinical laboratories inside the institution.

The LIS offers features such as order reception, specimen calculation, specimen identification or specimen acceptance, order check, scheduling, filler order management, production of worklists, result manual entry for non connected-tests, clinical validation and interpretation of results, result reporting. Each LIS implements an Order Filler Actor for the profile LTW. In this profile, the LIS can act as Blood Product Filler

Actors & Transactions:

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Specification

Profile Status: Trial implementation

Documents: IHE Pathology and Laboratory Medicine Technical Framework:

• TMA Transfusion Medicine - Administration - Rev. 2.1 - Published 2019-10-22

Underlying Standards:

• HL7

See Also

Related Profiles

• Integration Profiles TMA depends on

• Patient Administration Management (PAM) and/or Patient Demographics Query (PDQ) provide accurate patient demographics used by TMA: An application implementing one of the Actors Blood Product Documenter, Blood Product Filler shall also implement the Actors Patient Demographics Consumer and Patient Encounter Consumer from either PAM or PDQ Profile or both.

• Audit_Trail_and_Node_Authentication (ATNA) to audit creation and access to patient data during TMA. An application implementing one of the Actors Blood Product Documenter, Blood Product Filler shall also implement the Actor Secure Node from ATNA.
• Consistent_Time (CT) to ensure timestamps in TMA data and audit messages are accurate.

Consumer Information

This page is based on the Profile Template