CIO Interview: A digital journey from vein to vein

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Picture: Tony Carpinter, NZ Blood Service chief information officer

A wide range of initiatives is helping NZ Blood Service to manage not only the flow of blood products, but also the flow of digital information.

New Zealand Blood Service is becoming a more digital organisation via many different initiatives that range from small steps to big leaps.

NZBS is the crown entity responsible for the provision of blood products to the people of New Zealand. It operates as a “vein-to-vein” service, starting with taking blood from donors, and ending with patients receiving blood products. In between, there are testing, manufacturing and logistics processes.

NZBS is funded by selling blood products as required to DHBs. Beside the commercial relationship, NZBS also provides services to DHBs at the clinical level.

Donating blood is the first step in our core processes. We are totally dependent on donors generously giving their blood – either whole blood or plasma. We contact donors and ask them to come in, supported by a customer relationship management system that generates contact lists and allows us to contact donors through different channels.

Nowadays, donors can also use an app to make appointments to donate. This app also tells the donor “Congratulations, you saved a life today” when/if a blood product from this donation is given to a patient. It has been very successful for us.

Our future plans for this area of the business revolve around improving the donor’s experience via IT, for example, by allowing donors to answer the standard questions before coming in or by using self-service kiosks when they arrive.

Electronic traceability

Once we have a blood donation, NZBS operates as a highly regulated pharmaceutical manufacturer. Blood is processed, labelled, tested and made available for distribution. For these core functions, we use eProgesa, a French system that is dominant in the niche blood service market.

We have full traceability of blood, both forwards and backwards through the supply chain. This means that if a donor reports a health issue after donating, we can withdraw all of the products that were manufactured from the original donation.

There is a whole layer of automation in place now to support the steps in the manufacturing and testing processes. For example, an analyser carries out specialised tests on a set of blood samples. The results flow then from the analyser to a PC, then through middleware and into eProgesa. Similar processes occur later when a patient’s blood is cross-matched.

There are about 100 instances of this basic model within the organisation, using products from a range of vendors and covering various functions. The IS team is constantly involved in implementing new solutions of this type, which are becoming more complex.

Apps and anaytics

There is currently a drive to implement analytics to support key functions. We have developed sophisticated resource planning models which feed into decisions about staffing for blood collections. Backing our analytics, we have a mature data warehouse in place, and tools like Tableau are used in the business.

Further along the supply chain, NZBS provides stock to hospitals. When blood is allocated to patients within the public hospital system, the district health board blood banks all use the national eTraceline system , which is a sister product to eProgesa.

The three- to five-year roadmap for eTraceline includes items such as an upgrade to a new version with a web front-end, RFID blood tags and smart fridges, which can be controlled remotely and will simplify the release of blood in hospitals. We currently have a basic proof of concept in place of a ‘slightly smart’ fridge.

For compliance reasons, we need to move the labelling of blood products to ISBT 128, which is an international standard for blood products. This project is being scoped currently, and looks like a large piece of work, because it ripples through many systems.

A niche app is currently being used in two large DHBs to guide clinicians through an approval process to prescribe immunoglobulin. This is an expensive blood-derived product used to improve immunity in various circumstances. The app is replacing a cumbersome manual process.

From blood flows to information flows

Along with flows of blood products, there are flows of digital information. For DHB blood transactions, HL7 messages are generated and sent to the DHB clinical data repositories. There are demands to broaden and extend these flows further, for example, to private hospitals.

Moving away these core processes, NZBS also has the usual back-office functions to support. These functions need to become more digital, and a scoping study has just been completed. An electronic rostering and time and attendance solution has been implemented recently.

For the IS function, there is a large burden of application testing for the two core systems, and a tender for automated software testing is about to take place.

In line with the government direction of ‘cloud first’, NZBS has started its cloud migration. The model is a hybrid one: business systems can move into the cloud, but core manufacturing systems will remain within New Zealand for some time to come.

The first significant project is to move Microsoft Exchange to the cloud version, and this is under way. Office 365 will follow.

Tissue typing

Besides blood processing, NZBS has one other critical function, its tissue typing service. Tissue typing is involved in the matching, for example, of kidney donors and recipients. Scientifically and in IT terms, this is a more sophisticated operation than the blood processes, and it includes automated functions like DNA sequencing and complex algorithms for matching organ donors and recipients.

There is an exciting new development in this area, with a government decision to allocate New Zealand’s overall organ donation function to NZBS. Legislation has been introduced, but the full implications are not clear yet.

Overall, like the health sector in general, NZBS is steadily building its digital future.

Tony Carpinter is the chief information officer for NZ Blood Service.

Read more CIO Interviews:

Geoff King: CIO Interview: Delivering on diverse fronts

Darren Manly: CIO Interview: The key to health system transformation – good old-fashioned teamwork