Gordon William J, Baronas Jane, Lane William J
William Gordon, MD, 41 Avenue Louis Pasteur #209, Boston MA 02115, Phone: 617-264-08711, Email:
Appl Clin Inform. 2017 Jun 7;8(2):603-611. doi: 10.4338/ACI-2017-01-CR-0010.
Platelet transfusions are a cornerstone of therapy for patients who develop thrombocytopenia while undergoing Hematopoietic Stem Cell Transplantation (HSCT). Many patients who develop Platelet Transfusion Refractoriness (PTR) require HLA-matched platelets. Identifying these patients early could lead to better utilization of platelets as well as increased platelet counts. We built a SMART on FHIR visualization tool to aid the oncology, blood bank, and blood donor center teams in identifying these patients by showing trends in thrombocytopenia along with a computer generated calculated Panel Reactive Antibody (cPRA) level. To do this, we required a FHIR interface to our HLA database. We describe our methods and outcome for constructing this FHIR interface, as well as the architecture and data flow of HLA data from its proprietary database to the SMART on FHIR environment and application database along with RESTful cPRA web service calculator. Future work will evaluate the clinical impact of this platelet visualization tool and overall success of our FHIR implementation.
血小板输注是造血干细胞移植（HSCT）期间发生血小板减少症患者治疗的基石。许多发生血小板输注无效（PTR）的患者需要 HLA 匹配的血小板。早期识别这些患者可更好地利用血小板并提高血小板计数。我们构建了一个基于 FHIR 的智能可视化工具，通过展示血小板减少症的趋势以及计算机生成的计算面板反应性抗体（cPRA）水平，帮助肿瘤学、血库和献血中心团队识别这些患者。为此，我们需要一个连接 HLA 数据库的 FHIR 接口。我们描述了构建此 FHIR 接口的方法和结果，以及 HLA 数据从其专有数据库到基于 FHIR 的智能环境和应用数据库的架构和数据流，以及 RESTful cPRA 网络服务计算器。未来的工作将评估此血小板可视化工具的临床影响以及我们 FHIR 实施的整体成功情况。
