Over the past eight years, UH has reduced blood transfusions by 40 percent across its system, improved transfusion appropriateness, avoided increases in adverse outcomes, and generated approximately $55 million in cumulative savings. Those results were not driven by hard stops, punitive oversight, or rigid utilization controls. Instead, they came from a deliberate focus on education—using trusted, patient-specific data to help physicians understand and refine their own practice.
That approach led UH to develop HemaLogiX™, an analytics platform designed to evaluate the appropriateness of every transfusion using real clinical context. Retrospective analytics became the foundation of a transfusion stewardship model that clinicians trusted because it was fair, transparent, and grounded in evidence.
Now, UH and Hemaptics are taking the next major step forward.
Building on years of proven success with retrospective analytics, the platform has been enhanced with real-time clinical decision support embedded directly in the Epic electronic health record. This new capability delivers advisory feedback at the time a transfusion is ordered—reinforcing evidence-based practice while preserving physician autonomy.
Crucially, this is not a shift away from what already works. It is an extension of it.
Educating Physicians Through Fair, Trusted Data
At Hemaptics, our viewpoint is simple: lasting change in clinical practice comes from education, not enforcement. The success of transfusion stewardship at UH underscores that principle.
Traditional transfusion reports often rely on raw utilization metrics or static thresholds that fail to account for patient complexity. HemaLogiX takes a fundamentally different approach by normalizing transfusion data across all patients using a proprietary Transfusion Appropriateness Algorithm, which evaluates patient-specific variables including vital signs, medications and lab values.
The result is an appropriateness score that enables meaningful, like-for-like comparisons:
• Across departments
• Across facilities
• And most importantly, across physicians practicing in the same clinical context
This normalization is a critical part of the platform’s effectiveness. Physicians trust the data because it reflects their patients—not abstract benchmarks or generalized targets.
Focusing Attention Where Improvement Matters Most
Focus is a core strength of retrospective analysis. By filtering out transfusions that are clearly appropriate, HemaLogiX allows clinicians and stewardship teams to concentrate on the cases with the greatest opportunity for improvement.
The platform makes it easy to drill from system-level trends down to individual patient encounters, supporting efficient chart review and collaborative discussion around transfusion events. This capability turns data into dialogue—and dialogue into improvement.
Importantly, this process is not punitive. It is designed to support learning, reinforce evidence-based practice, and promote consistency across providers without disrupting workflow.
“Clinicians engage when the information is objective and relevant to their practice,” says Jennifer Dawson, MBA, MSN, RN, Principal Advisor, System Resource Utilization at University Hospitals and a founding clinical leader of the HemaLogiX initiative. “When you give them clear, patient-specific insight and the ability to explore the data themselves, behavior changes naturally.”
Adding Real-Time Insight at the Point of Care
While retrospective analytics have proven highly effective, decisions are addressed after they occur. Recognizing the impact of education at the moment of decision-making, UH and Hemaptics have introduced a real-time clinical decision support module within Epic. The newly released module represents a significant evolution of the platform.
When blood components are ordered in Epic, HemaLogiX now evaluates the order in real time against patient-specific data and HemaLogiX’s proprietary Transfusion Appropriateness Algorithm. If documented data does not meet set transfusion criteria, the system generates an advisory alert at the point of order entry. Clinicians retain full authority to override the alert and proceed with the transfusion, ensuring that clinical judgment remains paramount.
The intent is not to block care or mandate behavior, but to reinforce best practices at the point of care.
“Real-time alerts work best when they complement—not replace—retrospective review,” explains James L. Hill Jr. MD, MBA, CPE, FASA, FACHE, Chief Operating Officer, UH Parma, and a founding clinical leader of the HemaLogiX initiative. “The longitudinal analytics build understanding and trust. The alerts extend that same educational framework into the workflow.”
Why Retrospective and Real-Time Must Work Together
From our perspective, the most effective transfusion management programs require both:
• Retrospective analytics enabling fair peer comparison, education, and deep clinical review
• Real-time feedback reinforcing evidence-based practice when orders are placed
Together, these capabilities form a closed feedback loop. Clinicians learn from historical patterns, apply that knowledge prospectively, and then review outcomes in a transparent, data-driven way.
“The goal is not compliance—it’s competence,” Dr. Asher notes. “When physicians understand the data and see how it applies to their patients, improvement follows.”
A Scalable Model for Sustainable Change
What began as an internal solution at University Hospitals has evolved into a scalable model for transfusion stewardship nationwide. By combining trusted retrospective analytics with real-time clinical insight, HemaLogiX supports safer care, lower cost, and more consistent practice—without undermining clinical autonomy.
As health systems face mounting pressure to improve quality while controlling costs, transfusion management offers a clear opportunity for impact. UH’s experience demonstrates that the most durable gains come not from enforcement, but from education—supported by trusted data.
