Views sought on the implementation of ISBT128 - please read and comment

Introduction of ISBT128 Labelling.

The National Blood Centre is in the process of introducing a single label incorporating both CODABAR and ISBT128 barcode numbers on every blood donation commencing the 14th of June 2010. Hospital blood banks have sought for many years the introduction of a unique system of barcoding blood packs and very much welcome the benefits of ISBT128. However we understand that the current impetus for driving this project is that a number of hospital blood bank computer systems cannot accept blood donation entries carrying a repeat number. The proposed solution from the IBTS is to introduce a dual label on the blood pack and to allow each customer choose one or the other. The use of dual labelling is a reasonable approach when introducing such a change but the dual system would only operate for a limited period of time after which all hospital blood banks would have converted to the new system and the old system becomes obsolete. We now understand that the IBTS IT System, Progesa, cannot support ISBT128 and a replacement or upgrade will not take place for at least another 2 and more likely 4 years. The IBTS itself will still continue to use CODABAR as its official symbology.
What we are facing for the next 4 years or longer is a dual labelling system of blood packs, with some hospitals and the IBTS using CODABAR and some using ISBT128 and to compound the problem the dual numbers are located on the same label.
Following yesterdays information session at the IBTS we have been contacted by a number of hospital blood banks expressing concerns that the IBTS in trying to solve a problem which affects them directly may in turn be creating a greater problem for a large majority of their customers. Indeed without further risk assessment we could be creating a logistical problem that might take years to unravel.
Below are a number of the issues and questions raised at yesterday’s meeting.

• We understand that the IBTS IT system Progesa will not be in a position to accept ISBT128 for at least another 2 years. Therefore we will be in transition for a minimum of 2 years and possibly a lot longer.
• Assuming CODABAR is the official barcoding system IBTS, what is the standing of the new ISBT128 label.
• If a hospital has an unanticipated problem with 128 labelling who is liable, the IBTS for issuing it or the hospital for using an unofficial system
• All documentation coming from the IBTS will be in CODABAR format.
• Will the use of 2 different barcode symbologies be acceptable to the regulators.
• Is it safe to have the dual numbers on the same label.
• Transfer of products between hospitals using ISBT128 labels and hospitals using CODABAR may create problems of traceability.
• Documentation with blood accompanying transferring patients may be not be accepted at the receiving hospital.
• The risk of double booking when entering blood into stock, or when allocating or issuing product has the potential to create chaos with hospital blood bank systems.

The advisory body is fully supportive of the IBTS plan to introduce ISBT128 and the sooner the better. The present proposal is not receiving widespread approval and is a cause for concern at some hospital blood banks. We would also caution those blood banks that are eagerly awaiting the ISBT128 label to ensure that its introduction has been properly risk assessed.
It is also possible that this is the best and only solution to the current problem and we have no other option.
In order to evaluate the appetite for this change and to further the debate. The TTSAB Advisory Body would welcome members to add their comments and suggestions to this forum.

Paul O’Brien
TTSAB Advisory Body
Please send comments to P.OBrien@st-vincents.ie, or join the discussion on the Forum