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Circling the Dome

An Epic Savings

illustrated piggy bank giving blood

Johns Hopkins Medicine is on pace to save over $1.8 million this year by reducing unnecessary blood transfusions, thanks to efforts by the system’s Blood Management Program using the Epic electronic health records software program.

“Epic has improved our ability to do evidence-based transfusion practice,” says Steven Frank, director of the Johns Hopkins Blood Management Program. “Doing blood management is very data-intensive. We monitor transfusion guideline compliance. With the right data, you can improve practice by showing providers their compliance rates.”

Using interactive dashboards, Frank and colleagues can easily monitor usage of red blood cells, platelets and plasma by department, even drilling down to see the practice of individual providers. Reports are distributed to hospital departments monthly to encourage improved blood utilization and reduce unnecessary transfusions.

“We can show physicians their guideline compliance rates for transfusion compared with their peers,” Frank says. “We’ve found that’s the best way to improve practice.”  In addition, when physicians go to order blood products in the system, they see a best practice advisory supported by two reports in the New England Journal of Medicine, with links to the articles. “It tells the providers this is not just our opinion; these are the landmark studies supporting that less is more in terms of transfusion,” says Frank.

Building on a successful campaign to reduce unnecessary red blood cell use, when Epic went live in July 2016, Frank and colleagues added a push to reduce unnecessary platelet transfusions. “Platelets are the highest risk and the highest cost of all the major blood components, so it makes sense to reduce platelet overuse as well,” he says.

Through these efforts, Johns Hopkins Medicine is on track to save $800,000 through reduced platelet use, $716,000 through reduced red blood cell use and $296,000 through reduced plasma use for fiscal year 2017 compared with fiscal year 2014, before blood management was incorporated.