Extended RBC Phenotyping-genotyping FHIR IG (Jira PSS 1942)

The scope of the Extended RBC Phenotyping-genotyping FHIR IG is to expand red blood cell phenotype and antigen descriptions used to communicate blood component compatibility information in transfusion medicine. This IG will advance the bidirectional exchange of this information between healthcare facility blood bank laboratory information systems, donor center blood establishment computer systems, and electronic health record systems. Patient-specific and blood component-specific information will be included. The initial emphasis will be on red blood cell phenotypes and the underlying molecular descriptors of phenotype determination such as serologic methods, specific genotyping methods (e.g., array based, sequencing based, mass-array based), or gene sequencing methods.

Because of significant clinical overlap with patient allo- and auto-antibody determinations in ascertaining suitability of donor units for testing in a specific patient, it may be desirable to include patient antibody descriptors. Determination of this activity is deferred until the FHIR development activity has begun. Platelet and plasma phenotyping may be included in future efforts. Although U.S. Realm and U.S. Core Profiles may be used for initial work, the goal is to apply this IG internationally.

Determining RBC unit compatibility between patient and donor is a core function of transfusion medicine. With the advent of genotyping methods, phenotyping determination has expanded to population levels of donors and increasing numbers of patients, especially those who require chronic transfusions. Finding compatible blood for a patient with a low incidence antigen or one or more alloantibodies is becoming increasingly time consuming. While the International Society of Blood Transfusion (ISBT) maintains a controlled vocabulary to describe RBC phenotypic findings, a standard vocabulary for electronic bidirectional exchange of this extended information is needed.

Standardizing the electronic exchange of extensive phenotyping information for both biologically derived products (e.g., donor RBC units) and patients (e.g., sickle cell disease patients) improves patient care by supporting judicious use of RBC inventory and reducing the incidence of allo-antibody generation or early and delayed transfusion reactions. The uniform phenotyping representation provided by this FHIR IG can improve public health surveillance and safety of transfused products and potential sequalae by exchanging more granular information.