METHODS AND DEVICES FOR REDUCING TRANSFUSIONS DURING OR AFTER SURGERY AND FOR IMPROVING QUALITY OF LIFE AND FUNCTION IN CHRONIC DISEASE

• US 20130035951A1
• Filed: 02/02/2011
• Published: 02/07/2013
• Est. Priority Date: 02/02/2010
• Status: Active Grant

• Current Assignee: Accumen Inc.
• Original Assignee: Kathrine P. Frey
• Inventors: Frey, Kathrine P.
• Granted Patent: US 9,679,115 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

The present invention relates to methods of treating subjects preparing to undergo surgery or methods of treating chronic disease and methods for reducing transfusions and a computer readable storage medium and a physical computing device for carrying out these methods which include: a) receiving a profile of said subject, in a physical computing device, including a level of hemoglobin of said subject, level of creatinine of said subject, and information regarding current or past history of disease; b) applying said level of hemoglobin and said level of creatinine, in said physical computing device, to determine level of transfusion risk; c) applying said information regarding current or past history of disease of said subject, in said physical computing device, to determine level of comorbidity; d) applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine a patient care plan.

Claims

1. A method of treating a subject, said method comprising:

a) receiving a profile of said subject, in a physical computing device, wherein said profile comprises level of hemoglobin of said subject, level of creatinine of said subject, and information regarding current or past history of disease of said subject;

b) applying said level of hemoglobin and said level of creatinine, in said physical computing device, to determine level of transfusion risk;

c) applying said information regarding current or past history of disease of said subject, in said physical computing device, to determine level of comorbidity;

d) applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine a patient care plan; and

e) administering said patient care plan to treat said subject.

2. The method of claim 1, wherein said profile further comprises type of non-emergent surgery and red cell antibody information, and

wherein said method further comprises:

f) applying said type of said non-emergent surgery, in said physical computing device, to determine a range of anticipated loss of blood volume;

g) applying said range of anticipated loss of blood volume and said level of comorbidity, in said physical computing device, to determine a range of tolerable loss of blood volume;

h) applying said red cell antibody information, in said physical computing device, to determine one or more compatible blood types;

i) applying said range of anticipated loss of blood volume, said range of tolerable loss of blood volume, and said one or more compatible blood types, in said physical computing device, to determine an in-hospital transfusion minimization care plan; and

j) administering said in-hospital transfusion minimization care plan to treat said subject during or after undergoing said non-emergent surgery.

5. The method of claim 2, wherein said non-emergent surgery is an orthopedic surgery, a cardiovascular surgery, a genitourinary surgery, a gastrointestinal surgery, other vascular surgery, a gynecology surgery, a neurosurgery, an oncologic thoracic surgery, a high-risk caesarian delivery, or any combination thereof.

6. The method of claim 5, wherein said non-emergent surgery is said orthopedic surgery selected from the group consisting of primary or revision total knee replacement surgery that is single or bilateral, primary or revision partial knee replacement surgery that is single or bilateral, primary or revision total hip joint arthroplasty, and spine surgery;

said non-emergent surgery is said cardiovascular surgery selected from the group consisting of cardiac valve replacement, cardiac valve repair, coronary artery bypass surgery, coronary artery bypass surgery with cardiac valve repair or replacement, and aortic replacement surgery;

said non-emergent surgery is said genitourinary surgery selected from the group consisting of radical retropubic prostatectomy and cystectomy;

said non-emergent surgery is said gastrointestinal surgery, and said gastrointestinal surgery treats a cancer or an inflammatory bowel disease;

said non-emergent surgery is said vascular surgery for aneurysm repair;

said non-emergent surgery is said gynecology surgery selected from the group consisting of hysterectomy with or without bilateral salpingo-oophorectomy, tumor debulking, omentectomy, and lymph node sampling;

said non-emergent surgery is said neurosurgery selected from the group consisting of meningioma resection and surgery to correct vascular malformation;

or said non-emergent surgery is said oncologic thoracic surgery for removal of a lung tumor.

7. The method of claim 1, wherein said profile further comprises information regarding a health insurance plan and a health insurance provider of said subject, and

wherein said method further comprises:

comparing, in said physical computing device, a medical procedure, a laboratory test, a treatment, or a medication indicated in said patient care plan, said in-hospital transfusion minimization care plan, said first test panel, and/or said second test panel with the types of medical procedure, laboratory test, treatment, or medication allowed or restricted by said health insurance plan;

determining, in said physical computing device, whether coverage of said patient care plan, said in-hospital transfusion minimization care plan, said first test panel, and/or said second test panel requires pre-authorization by the subject'"'"'s healthcare provider; and

requesting and documenting, in said physical computing device, approval of said pre-authorization by said health insurance provider.

8. The method of claim 1, wherein said patient care plan comprises one or more of oral iron, intravenous iron, an erythropoietic medication, folate, vitamin B12, desmopressin acetate, preoperative dialysis, preoperative coagulation therapy, preoperative autologous blood donation, cell saver, postoperative iron, use of pediatric blood tubes for blood draws, or discontinuation of one or more anticoagulant medications between about one week to about two weeks before the date of non-emergent surgery.

9. The method of claim 1, wherein hospital transfusion minimization plan comprises use of a transfusion product having a shelf age of less than 14 days.

10. The method of claim 1, wherein said profile further comprises weight, gender, age, date of non-emergent surgery, level of creatinine, information regarding whether non-emergent surgery is a redo procedure, and/or information regarding whether non-emergent surgery is a non-isolated procedure;

and wherein applying said profile, in said physical computing device, to determine said level of transfusion risk comprises;

i. applying said level of hemoglobin to determine a first value, wherein if said level of hemoglobin is between 10.0 g/dL-11.4 g/dL, then said first value is two, wherein if said level of hemoglobin is above 11.4 g/dL and below 13.0 g/dL, then said first value is one, and wherein if said level of hemoglobin is more than or equal to 13.0 g/dL, then said first value is zero;

ii. applying said weight to determine a second value, wherein if said weight is less than 50 kg, the said second value is two, wherein if said weight is between 50 kg-75 kg, then said second value is one, and wherein if said weight is more than 75 kg, then said second value is zero;

iii. applying said gender to determine a third value, wherein if said gender is female, then said third value is one, and wherein if said gender is male, then said third value is zero;

iv. applying said age to determine a fourth value, wherein if said age is more than or equal to 65 years, then said fourth value is one, and wherein if said age is less than 65 years, then said fourth value is zero;

v. optionally applying said date of said non-emergent surgery to determine a fifth value, wherein if said date of said non-emergent surgery is less than two weeks away, then said fifth value is one, and wherein if said date of said non-emergent surgery is more than or equal to two weeks away, then said fifth value is zero;

vi. applying said level of creatinine to determine a sixth value, wherein if said level of creatinine is more than or equal to 2.0 mg/dL, then said sixth value is two, wherein if said level of creatinine is between 1.2 mg/dL-1.9 mg/dL, then said sixth value is one, and wherein if said level of creatinine is less than 1.2 mg/dL, then said sixth value is zero;

vii. optionally applying said information regarding whether said non-emergent surgery is a redo procedure to determine a seventh value, wherein if said non-emergent surgery is a redo procedure, then said seventh value is one, and wherein if said non-emergent surgery is not a redo procedure, then said seventh value is zero;

viii. optionally applying said information regarding whether said non-emergent surgery is a non-isolated procedure to determining an eighth value, wherein if said non-emergent surgery is a non-isolated procedure, then said eighth value is one; and

wherein if said non-emergent surgery is an isolated procedure, then said eighth value is zero; and

ix. outputting said level of transfusion risk to one or more of a computer readable medium, a server, a network, a display device, or a printed report, wherein;

if the sum of said first value to said eighth value is less than or equal to one, then said level of transfusion risk is low;

if the sum of said first value to said eighth value is two, then said level of transfusion risk is intermediate;

if the sum of said first value to said eighth value is three, then said level of transfusion risk is high; and

if the sum of said first value to said eighth value is more than three, then said level of transfusion risk is very high; and

wherein applying said profile to determine said level of comorbidity comprises applying said information regarding current or past history of disease to determine said level of comorbidity, wherein if said information regarding current or past history of disease comprises past history of cardiovascular disease, cerebrovascular disease, pulmonary disease, renal disease, cancer, autoimmune disease, gastrointestinal disease, inflammatory disease, active infection, or blood clotting disorder, then said level of comorbidity comprises one or more comorbid conditions.

11. The method of claim 10, wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan comprises:

i. determining whether said level of hemoglobin results in said first value being one or zero;

ii. determining whether said level of transfusion risk is low, intermediate, high, or very high;

iii. determining whether said level of comorbidity comprises one or more comorbid conditions; and

iv. selecting said patient care plan based on said level of hemoglobin, said level of transfusion risk, and said one or more comorbid conditions, wherein;

if said first value is zero, said level of transfusion risk is low or intermediate, and said one or more comorbid conditions are not present, then said patient care plan comprises one or more of oral iron, ascorbic acid, or a multivitamin;

if said one or more comorbid conditions are present, then said patient care plan comprises one or more of an erythropoietic medication, intravenous iron, oral iron, desmopressin acetate, preoperative dialysis, preoperative coagulation therapy, or preoperative autologous blood donation; and

if said first value is one or said level of transfusion risk is high or very high, then said patient care plan comprises one or more of intravenous iron, cell saver, preoperative autologous blood donation, postoperative iron, or use of pediatric blood tubes for blood draws.

12. The method of claim 11, wherein said profile further comprises information regarding medication taken by said subject, and

wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan further comprises:

v. applying said information regarding medication taken by said subject to determine a ninth value, wherein if said information regarding medication taken by said subject comprises one or more anticoagulant medications, then said ninth value is positive; and

vi. applying said ninth value to further determine said patient care plan, wherein if said ninth value is positive, then said patient care plan further comprises discontinuation of said one or more anticoagulant medications between about one week to about two weeks before said date of said non-emergent surgery.

13. The method of claim 12, wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan further comprises:

vii. applying said date of said non-emergent surgery to determine a tenth value, wherein if said date of said non-emergent surgery is more than one week away, then said tenth value is zero; and

viii. applying said first value and said tenth value to further determine said patient care plan, wherein if said first value is positive and said tenth value is zero, then said patient care plan further comprises administration of one or more of oral iron, intravenous iron, ferric carboxymaltose, iron sucrose, iron dextran, ascorbic acid, erythropoietin, folate, vitamin B12, epoetin, epoetin alfa, darbepoetin alfa, epoetin delta, PDpoetin, or methoxy polyethylene glycol-epoetin beta.

14. The method of claim 1, wherein said method further comprises:

k) receiving a revised level of hemoglobin of said subject, in said physical computing device, wherein said revised level of hemoglobin is determined after said subject is treated with said patient care plan;

l) receiving a revised profile of said subject, in said physical computing device, wherein said revised profile is determined after said subject is treated with said patient care plan;

m) applying said revised level of hemoglobin and said revised profile, in said physical computing device, to determine a revised level of transfusion risk;

n) applying said revised level of hemoglobin and said revised level of transfusion risk, in said physical computing device, to determine a revised patient care plan; and

o) outputting said revised level of hemoglobin and said revised patient care plan to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

15. The method of claim 14, wherein said revised profile further comprises revised weight, gender, revised age, revised date of non-emergent surgery, revised level of creatinine, revised information regarding whether or not non-emergent surgery is a redo procedure, and/or revised information regarding whether or not non-emergent surgery is a non-isolated procedure.

16. The method of claim 1, wherein applying said level of comorbidity, in said physical computing device, to determine an in-hospital transfusion minimization care plan comprises:

i. determining whether said level of comorbidity comprises one or more comorbid conditions; and

ii. selecting a transfusion product based on said level of comorbidity, wherein if said one or more comorbid conditions are present, then said transfusion product has a shelf age of less than 14 days.

17. The method of claim 1, wherein said method further comprises:

p) receiving information regarding said subject after undergoing non-emergent surgery, in said physical computing device, wherein said information regarding said subject after undergoing said non-emergent surgery comprises information regarding loss of blood volume during said non-emergent surgery, information regarding whether said subject had a transfusion during said non-emergent surgery, and information regarding adverse events;

q) applying said information regarding said subject after undergoing said non-emergent surgery, said profile, said level of transfusion risk, said level of comorbidity, said patient care plan, and said in-hospital transfusion minimization care plan, in said physical computing device, to determine a patient outcome report; and

r) outputting said patient outcome report to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

18. The method of claim 1, wherein said method further comprises:

s) applying said profile, in said physical computing device, to determine level of bleeding risk;

t) applying said level of hemoglobin, said level of creatinine, and said level of bleeding risk, in said physical computing device, to determine a first test panel, wherein said first test panel indicates whether or not one or more laboratory tests need to be performed;

u) applying red cell antibody information, in said physical computing device, to determine a second test panel, wherein said second test panel indicates whether or not one or more laboratory tests need to be performed; and

v) outputting said first test panel and said second test panel to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

19. The method of claim 18, wherein said profile further comprises information regarding medication taken by said subject, and

wherein applying said profile, in said physical computing device, to determine said level of bleeding risk comprises:

i. applying said information regarding current or past history of disease to determine an eleventh value, wherein if said information regarding current or past history of disease comprises past history of bleeding, then said eleventh value is positive; and

ii. applying said information regarding medication taken by said subject to determine a twelfth value, wherein;

if said information regarding medication taken by said subject comprises one or more procoagulant medications, then said twelfth value is positive; and

if one or more of said eleventh value to said twelfth value are positive, then said level of bleeding risk is high.

20. The method of claim 19, wherein applying said level of bleeding risk, in said physical computing device, to determine said first test panel comprises:

i. using said eleventh value and twelfth value to determine said level of bleeding risk; and

ii. selecting said one or more laboratory tests if said level of bleeding risk is high, wherein said one or more laboratory tests are selected from the group consisting of a screening coagulation panel and a special coagulation test.

21. The method of claim 18, wherein applying said level of hemoglobin and said level of creatinine, in said physical computing device, to determine said first test panel comprises:

i. applying said level of hemoglobin to determine whether said subject is anemic or whether said level of hemoglobin has been determined recently;

ii. selecting said one or more laboratory tests if said subject is anemic or if said level of hemoglobin is not recent, wherein said one or more laboratory tests are selected from the group consisting of an iron assessment panel, a complete blood count, a hemoglobin test, a vitamin B12 test, a folate test, and a C reactive protein assay;

iii. applying said level of creatinine to determine whether said level of creatinine has been determined recently; and

iv. selecting said one or more laboratory tests if said level of creatinine is not recent, wherein said one or more laboratory tests are selected from the group consisting of a creatinine test with calculated glomerular filtration rate and a blood urea nitrogen test.

22. The method of claim 18, wherein applying said red cell antibody information, in said physical computing device, to determine said second test panel comprises:

i. applying said red cell antibody information to determine whether one or more red cell antibodies are present; and

ii. selecting said one or more laboratory tests if said one or more red cell antibodies are present, wherein said one or more laboratory tests are selected from the group consisting of a red cell antibody identification test, a direct antiglobulin test, an indirect antiglobulin test, and a blood typing test.

23. The method of claim 22, wherein said method further comprises outputting the results of said one or more laboratory tests if the one or more red cell antibodies are present, and providing said results to a healthcare provider to ensure that blood components compatible with the one or more red cell antibodies are available for transfusion during said non-emergent surgery.

24. The method of claim 18, wherein said method further comprises:

w) applying said information regarding current or past history of disease, in said physical computing device, to determine level of renal risk, wherein if said information regarding current or past history of disease comprises current or past history of renal disease or current or past history of diabetes, then said level of renal risk is high;

x) applying said level of renal risk, in said physical computing device, to determine a third test panel, wherein said third test panel indicates whether one or more laboratory tests need to be performed, and wherein if said level of renal risk is high, then said third test panel comprises one or more of a creatinine test with calculated glomerular filtration rate or a blood urea nitrogen test; and

y) outputting said third test panel to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

25. The method of claim 24, wherein if said level of renal risk is high, then said patient care plan further comprises a consultation with a renal specialist, and wherein if said level of creatinine is more than 2 mg/dL, then said patient care plan further comprises dialysis.

26. The method of claim 1, further comprising outputting a patient satisfaction outcome report, a hospital satisfaction outcome report, an adverse event outcome report, or a surgical outcome-specific report comprising said patient care plan, said in-hospital transfusion minimization care plan, said revised patient care plan, said first test panel, said second test panel, and/or said third test panel to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

75. A physical computing device comprising a processor, a memory, and an interconnection mechanism coupling said processor and said memory, wherein said memory comprises data and an executable code that causes said processor to perform a method of claim 1.

3. A method of treating a subject, said method comprising:

a) receiving a profile of said subject, in a physical computing device, wherein said profile comprises level of hemoglobin of said subject, level of creatinine of said subject, and information regarding current or past history of disease of said subject;

b) applying said level of hemoglobin and said level of creatinine, in said physical computing device, to determine level of transfusion risk using a physical computing device, wherein said applying comprises comparing said level of hemoglobin to a predetermined threshold for hemoglobin, wherein said level of hemoglobin lower than said predetermined threshold indicates increased level of transfusion risk, and comparing said level of creatinine to a predetermined threshold for creatinine, wherein said level of creatinine higher than said predetermined threshold indicates increased level of transfusion risk;

c) applying said information regarding current or past history of disease of said subject, in said physical computing device, to determine level of comorbidity using a physical computing device, wherein said applying comprises comparing said information to a predetermined comorbid condition and wherein the presence of said predetermined comorbid condition in said information indicates increased level of comorbidity;

d) applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine a patient care plan using a physical computing device, wherein said determining comprises comparing said level of hemoglobin to a predetermined value of hemoglobin indicative of anemia and said patient care plan comprises one or more treatments for said anemia, said increased level of transfusion risk, or said increased level of comorbidity; and

e) administering said patient care plan to treat said subject.

4. The method of claim 3, wherein said profile further comprises type of non-emergent surgery and red cell antibody information, and

wherein said method further comprises:

f) applying said type of said non-emergent surgery, in said physical computing device, to determine a range of anticipated loss of blood volume, wherein said applying comprises comparing said type of said non-emergent surgery to a predetermined threshold range of anticipated loss of blood volume;

g) applying said range of anticipated loss of blood volume and said level of comorbidity, in said physical computing device, to determine a range of tolerable loss of blood volume, wherein said applying comprises determining said range of tolerable loss of blood volume based on a minimum tolerable hematocrit associated with said level of comorbidity;

h) applying said red cell antibody information, in said physical computing device, to determine one or more compatible blood types, wherein said applying comprises determining one or more blood types compatible with the presence of one or more red cell antibodies identified in said red cell antibody information;

i) applying said range of anticipated loss of blood volume, said range of tolerable loss of blood volume, and said one or more compatible blood types, in said physical computing device, to determine an in-hospital transfusion minimization care plan, wherein said in-hospital transfusion minimization care plan comprises use of one or more blood components having said range of anticipated loss of blood volume and having said compatible blood type when said subject loses more blood than said range of tolerable loss of blood volume during said non-emergent surgery; and

j) administering said in-hospital transfusion minimization care plan to treat said subject during or after undergoing said non-emergent surgery.

27. A method of treating a subject, said method comprising:

a) receiving a profile of said subject, in a physical computing device, wherein said profile comprises level of hemoglobin of said subject, level of creatinine of said subject, information regarding current or past history of disease of said subject, and red cell antibody information of said subject;

b) receiving a patient care plan, in said physical computing device, wherein said level of hemoglobin, said level of creatinine, and said profile is used to determine said patient care plan;

c) administering said patient care plan to treat said subject;

d) managing said subject though notification and support, in said physical computing device;

e) optionally receiving an in-hospital transfusion minimization care plan, in said physical computing device, comprising a range of anticipated loss of blood volume, a range of tolerable loss of blood volume, and one or more compatible blood types, wherein said profile is used to determine said range of anticipated loss of blood volume, said range of tolerable loss of blood volume, and said one or more compatible blood types; and

f) optionally administering said in-hospital transfusion minimization care plan to treat said subject.

28. A method of continuously treating a subject having a chronic disease, said method comprising:

a) receiving a profile of said subject, in a physical computing device, wherein said profile comprises level of hemoglobin of said subject and level of blood health index of said subject;

b) applying said level of hemoglobin or said level of blood health index, in said physical computing device, to determine a patient care plan;

c) administering said patient care plan to treat said subject;

d) selecting one or more laboratory tests, in said physical computing device, wherein said one or more laboratory tests are selected from the group consisting of a creatinine test, a glomerular filtration rate test, a vitamin B12 test, and a folate test;

e) receiving a revised level of hemoglobin of said subject or a revised level of blood health index of said subject, in said physical computing device, wherein said revised levels are determined after said subject is treated with said patient care plan and said revised levels are determined on a continuous basis for a year;

f) applying said revised level of hemoglobin or said revised level of blood health index, in said physical computing device, to determine a revised patient care plan; and

g) administering said revised patient care plan to treat said subject.

30. The method of claim 28, wherein said chronic disease is selected from the group consisting of a chronic heart failure, an inflammatory gastrointestinal disease, a rheumatologic inflammatory disease, a chronic viral disease, a chronic inflammatory state, a gynecological state, and a post-surgical state.

31. The method of claim 30, wherein said chronic disease is said chronic viral disease selected from the group consisting of hepatitis C infection, hepatitis B infection, and HIV infection;

or said chronic disease is said chronic inflammatory state selected from the group consisting of diabetes, chronic renal disease, and obesity.

32. The method of claim 28, wherein said profile further comprises information regarding a health insurance plan and a health insurance provider of said subject, and wherein said method further comprises:

comparing, in said physical computing device, a medical procedure, a laboratory test, a treatment, or a medication indicated in said patient care plan with the types of medical procedure, laboratory test, treatment, or medication allowed or restricted by said health insurance plan;

determining, in said physical computing device, whether coverage of said patient care plan requires pre-authorization by the subject'"'"'s healthcare provider; and

requesting and documenting, in said physical computing device, approval of said pre-authorization by said health insurance provider.

33. The method of claim 28, wherein said patient care plan comprises one or more of oral iron, intravenous iron, an erythropoietic medication, folate, vitamin B12, desmopressin acetate, or dialysis.

34. The method of claim 28, wherein said profile further comprises information regarding current or past history of disease of said subject and glomerular filtration rate and wherein said level of blood health index comprises one or more of level of serum iron, level of % iron saturation, level of ferritin, level of C reactive protein, mean corpuscular volume, mean corpuscular hemoglobin, level of vitamin B12, or level of folate.

35. The method of claim 34, further comprising applying said profile and said level of blood health index, in said physical computing device, to determine level of renal risk,

wherein if said history of disease includes diabetes or chronic renal disease and said level of blood health index is either more or less than said predetermined threshold for blood health index, then said level of renal risk is high, and

wherein said patient care plan for treating said high level of renal risk comprises administration of one or more medications from the group consisting of oral iron, intravenous iron, ferric carboxymaltose, iron sucrose, iron dextran, erythropoietin, folate, vitamin B12, epoetin, epoetin alfa, darbepoetin alfa, epoetin delta, PDpoetin, and methoxy polyethylene glycol-epoetin beta.

36. The method of claim 35, wherein said predetermined threshold for blood health index comprises one or more of level of serum iron of 35 μ

g/dL, level of % iron saturation of 25%, level of ferritin of 125 ng/mL, level of C reactive protein of 8 mg/L, mean corpuscular volume of 82 fL, or of 100 fL, or mean corpuscular hemoglobin of 30 pg, and

wherein said level of blood health index comprises one or more of level of serum iron equal to or less than 35 μ

g/dL, level of % iron saturation equal to or less than 25%, level of ferritin equal to or less than 125 ng/mL, level of C reactive protein equal to or more than 8 mg/L, mean corpuscular volume equal to or less than 82 μ

L and more than 100 fL, or mean corpuscular hemoglobin equal to or less than 30 pg.

37. The method of claim 28, wherein said method further comprises:

h) receiving a revised level of hemoglobin of said subject and a revised level of blood health index, in said physical computing device, wherein said revised levels are determined after said subject is treated with said patient care plan;

i) applying said revised level of hemoglobin and said revised level of blood health index, in said physical computing device, to determine a revised patient care plan; and

j) outputting said revised patient care plan to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

38. The method of claim 28, further comprising outputting a patient satisfaction outcome report, a hospital satisfaction outcome report, an adverse event outcome report, or a surgical outcome-specific report comprising said patient care plan, said revised patient care plan, and/or said one or more laboratory tests to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

29. A method of continuously treating a subject having a chronic disease, said method comprising:

a) receiving a profile of said subject, in a physical computing device, wherein said profile comprises level of hemoglobin of said subject and level of blood health index of said subject;

b) applying said level of hemoglobin or said level of blood health index, in said physical computing device, to determine a patient care plan, wherein said applying comprises comparing said level of hemoglobin to a predetermined threshold for hemoglobin, wherein said level of hemoglobin lower than said predetermined threshold indicates anemia;

comparing said level of blood health index to a predetermined threshold for blood health index, wherein said level of blood health index either higher or lower than said predetermined threshold indicates iron-depletion or iron-deficiency; and

selecting a patient care plan to treat said anemia, said iron-depletion, or said iron-deficiency;

c) administering said patient care plan to treat said subject;

d) selecting one or more laboratory tests, in said physical computing device, wherein said one or more laboratory tests are selected from the group consisting of a creatinine test, a glomerular filtration rate test, a vitamin B12 test, and a folate test;

e) receiving a revised level of hemoglobin of said subject or a revised level of blood health index of said subject, in said physical computing device, wherein said revised levels are determined after said subject is treated with said patient care plan and said revised levels are determined on a continuous basis for a year;

f) applying said revised level of hemoglobin or said revised level of blood health index, in said physical computing device, to determine a revised patient care plan, wherein said applying comprises comparing said revised level of hemoglobin to said predetermined threshold for hemoglobin, wherein said revised level of hemoglobin lower than said predetermined threshold indicates anemia;

comparing said revised level of blood health index to said predetermined threshold, wherein said level of blood health index either higher or lower than said predetermined threshold indicates iron-depletion or iron-deficiency; and

selecting said revised patient care plan to treat said anemia, said iron-depletion, or said iron-deficiency; and

g) administering said revised patient care plan to treat said subject.

39. A method of reducing transfusions during or after a non-emergent surgery, said method comprising:

a) receiving a profile of a subject preparing to undergo a non-emergent surgery, in a physical computing device, wherein said profile comprises level of hemoglobin of said subject, level of creatinine of said subject, and information regarding current or past history of disease of said subject;

b) applying said profile, in said physical computing device, to determine level of transfusion risk and level of comorbidity;

c) applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine a patient care plan;

d) applying said profile, in said physical computing device, to determine level of bleeding risk;

e) applying said level of hemoglobin, said level of creatinine, and said level of bleeding risk, in said physical computing device, to determine a first test panel, wherein said first test panel indicates whether or not one or more laboratory tests need to be performed; and

f) outputting said patient care plan and said first test panel to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

40. The method of claim 39, wherein said profile further comprises type of said non-emergent surgery and red cell antibody information of said subject, and wherein said method further comprises:

g) applying said type of said non-emergent surgery, in said physical computing device, to determine a range of anticipated loss of blood volume;

h) applying said range of anticipated loss of blood volume and said level of comorbidity, in said physical computing device, to determine a range of tolerable loss of blood volume;

i) applying said red cell antibody information, in said physical computing device, to determine one or more compatible blood types;

j) applying said range of anticipated loss of blood volume, said range of tolerable loss of blood volume, said one or more compatible blood types, and said level of comorbidity, in said physical computing device, to determine an in-hospital transfusion minimization care plan;

k) applying said red cell antibody information, in said physical computing device, to determine a second test panel, wherein said second test panel indicates whether or not one or more laboratory tests need to be performed; and

l) outputting said in-hospital transfusion minimization care plan and said second test panel to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

43. The method of claim 39, wherein said profile further comprises information regarding a health insurance plan and a health insurance provider of said subject, and wherein said method further comprises:

comparing, in said physical computing device, a medical procedure, a laboratory test, a treatment, or a medication indicated in said patient care plan, said in-hospital transfusion minimization care plan, said first test panel, and/or said second test panel with the types of medical procedure, laboratory test, treatment, or medication allowed or restricted by said health insurance plan;

determining, in said physical computing device, whether coverage of said patient care plan, said in-hospital transfusion minimization care plan, said first test panel, and/or said second test panel requires pre-authorization by the subject'"'"'s healthcare provider;

requesting and documenting, in said physical computing device, approval of said pre-authorization by said health insurance provider; and

outputting the results of said comparing, determining, requesting, and documenting steps to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

44. The method of claim 39, wherein said profile further comprises weight, gender, age, date of said non-emergent surgery, and information regarding whether said non-emergent surgery is a redo procedure, information regarding whether said non-emergent surgery is a non-isolated procedure;

and

wherein applying said profile, in said physical computing device, to determine said level of transfusion risk comprises;

i. applying said level of hemoglobin to determine a first value, wherein if said level of hemoglobin is between 10.0 g/dL-11.4 g/dL, then said first value is two, wherein if said level of hemoglobin is above 11.4 g/dL and below 13.0 g/dL, then said first value is one, and wherein if said level of hemoglobin is more than or equal to 13.0 g/dL, then said first value is zero;

ii. applying said weight to determine a second value, wherein if said weight is less than 50 kg, the said second value is two, wherein if said weight is between 50 kg-75 kg, then said second value is one, and wherein if said weight is more than 75 kg, then said second value is zero;

iii. applying said gender to determine a third value, wherein if said gender is female, then said third value is one, and wherein if said gender is male, then said third value is zero;

iv. applying said age to determine a fourth value, wherein if said age is more than or equal to 65 years, then said fourth value is one, and wherein if said age is less than 65 years, then said fourth value is zero;

v. applying said date of said non-emergent surgery to determine a fifth value, wherein if said date of said non-emergent surgery is less than two weeks away, then said fifth value is one, and wherein if said date of said non-emergent surgery is more than or equal to two weeks away, then said fifth value is zero;

vi. applying said level of creatinine to determine a sixth value, wherein if said level of creatinine is more than or equal to 2.0 mg/dL, then said sixth value is two, wherein if said level of creatinine is between 1.2 mg/dL-1.9 mg/dL, then said sixth value is one, and wherein if said level of creatinine is less than 1.2 mg/dL, then said sixth value is zero;

vii. applying said information regarding whether said non-emergent surgery is a redo procedure to determine a seventh value, wherein if said non-emergent surgery is a redo procedure, then said seventh value is one, and wherein if said non-emergent surgery is not a redo procedure, then said seventh value is zero;

viii. applying said information regarding whether said non-emergent surgery is a non-isolated procedure to determining an eighth value, wherein if said non-emergent surgery is a non-isolated procedure, then said eighth value is one; and

wherein if said non-emergent surgery is an isolated procedure, then said eighth value is zero; and

ix. outputting said level of transfusion risk to one or more of said computer readable medium, said server, said network, said display device, or said printed report, wherein;

if the sum of said first value to said eighth value is less than or equal to one, then said level of transfusion risk is low;

if the sum of said first value to said eighth value is two, then said level of transfusion risk is intermediate;

if the sum of said first value to said eighth value is three, then said level of transfusion risk is high; and

if the sum of said first value to said eighth value is more than three, then said level of transfusion risk is very high; and

wherein applying said profile to determine said level of comorbidity comprises applying said information regarding current or past history of disease to determine said level of comorbidity, wherein if said information regarding current or past history of disease comprises past history of cardiovascular disease, cerebrovascular disease, pulmonary disease, renal disease, cancer, autoimmune disease, gastrointestinal disease, or blood clotting disorder, then said level of comorbidity comprises one or more comorbid conditions.

45. The method of claim 44, wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan comprises:

i. determining whether said level of hemoglobin results in said first value being one or zero;

ii. determining whether said level of transfusion risk is low, intermediate, high, or very high;

iii. determining whether said level of comorbidity is comprises one or more comorbid conditions; and

iv. selecting said patient care plan based on said level of hemoglobin, said level of transfusion risk, and said one or more comorbid conditions, wherein;

if said first value is zero, said level of transfusion risk is low or intermediate, and said one or more comorbid conditions are not present, then said patient care plan comprises one or more of oral iron or a multivitamin;

if said one or more comorbid conditions are present, then said patient care plan comprises one or more of an erythropoietic medication, intravenous iron, oral iron, desmopressin acetate, preoperative dialysis, preoperative coagulation therapy, or preoperative autologous blood donation; and

if said first value is one or said level of transfusion risk is high or very high, then said patient care plan comprises one or more of intravenous iron, cell saver, preoperative autologous blood donation, postoperative iron, or use of pediatric blood tubes for blood draws.

46. The method of claim 45, wherein said profile further comprises information regarding medication taken by said subject, and

wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan further comprises:

v. applying said information regarding medication taken by said subject to determine a ninth value, wherein if said information regarding medication taken by said subject comprises one or more anticoagulant medications, then said ninth value is positive; and

vi. applying said ninth value to further determine said patient care plan, wherein if said ninth value is positive, then said patient care plan further comprises discontinuation of said one or more anticoagulant medications between about one week to about two weeks before said date of said non-emergent surgery.

47. The method of claim 46, wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan further comprises:

vii. applying said date of said non-emergent surgery to determine a tenth value, wherein if said date of said non-emergent surgery is more than one week away, then said tenth value is zero; and

viii. applying said first value and said tenth value to further determine said patient care plan, wherein if said first value is positive and said tenth value is zero, then said patient care plan further comprises one or more of oral iron, intravenous iron, ferric carboxymaltose, iron sucrose, iron dextran, ascorbic acid, erythropoietin, folate, vitamin B12, epoetin, epoetin alfa, darbepoetin alfa, epoetin delta, PDpoetin, or methoxy polyethylene glycol-epoetin beta.

48. The method of claim 39, wherein said method further comprises:

m) receiving a revised level of hemoglobin of said subject, in said physical computing device, wherein said revised level of hemoglobin is determined after said subject is treated with said patient care plan;

n) receiving a revised profile of said subject, in said physical computing device, wherein said revised profile is determined after said subject is treated with said patient care plan;

o) applying said revised level of hemoglobin and said revised profile, in said physical computing device, to determine a revised level of transfusion risk;

p) applying said revised level of hemoglobin and said revised level of transfusion risk, in said physical computing device, to determine a revised patient care plan; and

q) outputting said revised level of hemoglobin and said revised patient care plan to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

49. The method of claim 48, wherein said revised profile further comprises revised weight, gender, revised age, revised date of said non-emergent surgery, revised level of creatinine, revised information regarding whether said non-emergent surgery is a redo procedure, and revised information regarding whether said non-emergent surgery is a non-isolated procedure.

50. The method of claim 39, wherein said profile further comprises information regarding medication taken by said subject, and

wherein applying said profile, in said physical computing device, to determine said level of bleeding risk comprises:

i. applying said information regarding current or past history of disease to determine an eleventh value, wherein if said information regarding current or past history of disease comprises past history of bleeding, then said eleventh value is positive; and

ii. applying said information regarding medication taken by said subject to determine a twelfth value, wherein;

if said information regarding medication taken by said subject comprises one or more procoagulant medications, then said twelfth value is positive; and

if one or more of said eleventh value to said twelfth value are positive, then said level of bleeding risk is high.

51. The method of claim 50, wherein applying said level of bleeding risk, in said physical computing device, to determine said first test panel comprises:

i. using said eleventh value and twelfth value to determine said level of bleeding risk; and

ii. selecting said one or more laboratory tests if said level of bleeding risk is high, wherein said one or more laboratory tests are selected from the group consisting of a screening coagulation panel and a special coagulation test.

52. The method of claim 39, wherein applying said level of hemoglobin and said level of creatinine, in said physical computing device, to determine said first test panel comprises:

i. applying said level of hemoglobin to determine whether said subject is anemic or whether said level of hemoglobin has been determined recently;

ii. selecting said one or more laboratory tests if said subject is anemic or if said level of hemoglobin is not recent, wherein said one or more laboratory tests are selected from the group consisting of an iron assessment panel, a complete blood count, a hemoglobin test, a vitamin B12 test, a folate test, and a C reactive protein assay;

iii. applying said level of creatinine to determine whether said level of creatinine has been determined recently; and

iv. selecting said one or more laboratory tests if said level of creatinine is not recent, wherein said one or more laboratory tests are selected from the group consisting of a creatinine test with calculated glomerular filtration rate and a blood urea nitrogen test.

53. The method of claim 39, wherein applying said level of comorbidity, in said physical computing device, to determine an in-hospital transfusion minimization care plan comprises:

i. determining whether said level of comorbidity comprises one or more comorbid conditions; and

ii. selecting a transfusion product based on said level of comorbidity, wherein if one or more comorbid conditions are present, then said transfusion product has a shelf age of less than 14 days.

54. The method of claim 39, wherein applying said red cell antibody information, in said physical computing device, to determine said second test panel comprises:

i. applying said red cell antibody information to determine whether one or more red cell antibodies are present; and

ii. selecting said one or more laboratory tests if said one or more red cell antibodies are present, wherein said one or more laboratory tests are selected from the group consisting of a red cell antibody identification test, a direct antiglobulin test, an indirect antiglobulin test, and a blood typing test.

55. The method of claim 39, wherein said method further comprises:

r) applying said information regarding current or past history of disease, in said physical computing device, to determine level of renal risk, wherein if said information regarding current or past history of disease comprises current or past history of renal disease or current or past history of diabetes, then said level of renal risk is high;

s) applying said level of renal risk, in said physical computing device, to determine a third test panel, wherein said third test panel indicates whether or not one or more laboratory tests need to be performed, and wherein if said level of renal risk is high, then said third test panel comprises one or more of a creatinine test with calculated glomerular filtration rate or a blood urea nitrogen test; and

t) outputting said third test panel to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

56. The method of claim 39, wherein said method further comprises:

u) receiving information regarding said subject after undergoing said non-emergent surgery, in said physical computing device, wherein said information regarding said subject after undergoing said non-emergent surgery comprises information regarding loss of blood volume during said non-emergent surgery, information regarding whether said subject had a transfusion during said non-emergent surgery, and information regarding adverse events;

v) applying said information regarding said subject after undergoing said non-emergent surgery, said profile, said level of transfusion risk, said level of comorbidity, said patient care plan, and said in-hospital transfusion minimization care plan, in said physical computing device, to determine a patient outcome report; and

w) outputting said patient outcome report to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

57. The method of claim 39, wherein said method further comprises outputting a patient satisfaction outcome report, a hospital satisfaction outcome report, an adverse event outcome report, or a surgical outcome-specific report comprising said patient care plan, said in-hospital transfusion minimization care plan, said revised patient care plan, said first test panel, said second test panel, and/or said third test panel to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

41. A method of reducing transfusions during or after a non-emergent surgery, said method comprising:

a) receiving a profile of a subject preparing to undergo a non-emergent surgery, in a physical computing device, wherein said profile comprises level of hemoglobin of said subject, level of creatinine of said subject, and information regarding current or past history of disease of said subject;

b) applying said profile, in said physical computing device, to determine level of transfusion risk and level of comorbidity, wherein said applying comprises;

comparing said level of hemoglobin to a predetermined threshold for hemoglobin, wherein said level of hemoglobin lower than said predetermined threshold indicates increased level of transfusion risk;

comparing said level of creatinine to a predetermined threshold for creatinine, wherein said level of creatinine higher than said predetermined threshold indicates increased level of transfusion risk; and

comparing said information to a predetermined comorbid condition, wherein the presence of said predetermined comorbid condition in said information indicates increased level of comorbidity;

c) applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine a patient care plan, wherein said determining comprises comparing said level of hemoglobin to a predetermined value of hemoglobin indicative of anemia and said patient care plan comprises one or more treatments for said anemia, said increased level of transfusion risk, or said increased level of comorbidity;

d) applying said profile, in said physical computing device, to determine level of bleeding risk, wherein said applying comprises comparing said information to a predetermined bleeding risk condition and wherein the presence of said predetermined bleeding risk condition in said information indicates increased level of bleeding risk;

e) applying said level of hemoglobin, said level of creatinine, and said level of bleeding risk, in said physical computing device, to determine a first test panel, wherein said first test panel indicates whether or not one or more laboratory tests need to be performed; and

f) outputting said patient care plan and said first test panel to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

42. The method of claim 41, wherein said profile further comprises type of said non-emergent surgery and red cell antibody information of said subject, and

wherein said method further comprises:

g) applying said type of said non-emergent surgery, in said physical computing device, to determine a range of anticipated loss of blood volume, wherein said applying comprises comparing said type of said non-emergent surgery to a predetermined threshold range of anticipated loss of blood volume;

h) applying said range of anticipated loss of blood volume and said level of comorbidity, in said physical computing device, to determine a range of tolerable loss of blood volume, wherein said applying comprises determining said range of tolerable loss of blood volume based on a minimum tolerable hematocrit associated with said level of comorbidity;

i) applying said red cell antibody information, in said physical computing device, to determine one or more compatible blood types, wherein said applying comprises determining one or more blood types compatible with the presence of one or more red cell antibodies identified in said red cell antibody information;

j) applying said range of anticipated loss of blood volume, said range of tolerable loss of blood volume, said one or more compatible blood types, and said level of comorbidity, in said physical computing device, to determine an in-hospital transfusion minimization care plan, wherein said in-hospital transfusion minimization care plan comprises use of one or more blood components having said range of anticipated loss of blood volume and having said compatible blood type when said subject loses more blood than said range of tolerable loss of blood volume during said non-emergent surgery;

k) applying said red cell antibody information, in said physical computing device, to determine a second test panel, wherein said second test panel indicates whether or not one or more laboratory tests need to be performed; and

l) outputting said in-hospital transfusion minimization care plan and said second test panel to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

58. A computer readable storage medium comprising executable code, wherein said executable code causes a physical computing device to perform a method comprising:

a) receiving data comprising a profile of a subject, in said physical computing device, wherein said profile comprises level of hemoglobin of said subject, level of creatinine of said subject, and information regarding current or past history of disease of said subject;

b) applying said profile, in said physical computing device, to determine level of transfusion risk and level of comorbidity;

c) applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine a patient care plan;

d) applying said profile, in said physical computing device, to determine level of bleeding risk;

e) applying said level of hemoglobin, said level of creatinine, and said level of bleeding risk, in said physical computing device, to determine a first test panel, wherein said first test panel indicates whether or not one or more laboratory tests need to be performed; and

f) outputting said patient care plan and said first test panel to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

59. The computer readable storage medium of claim 58, wherein said profile further comprises type of non-emergent surgery and red cell antibody information of said subject, and

wherein said method further comprises:

g) applying said type of said non-emergent surgery, in said physical computing device, to determine a range of anticipated loss of blood volume;

h) applying said range of anticipated loss of blood volume and said level of comorbidity, in said physical computing device, to determine a range of tolerable loss of blood volume;

i) applying said red cell antibody information, in said physical computing device, to determine one or more compatible blood types;

j) applying said range of anticipated loss of blood volume, said range of tolerable loss of blood volume, said one or more compatible blood types, and said level of comorbidity, in said physical computing device, to determine an in-hospital transfusion minimization care plan;

k) applying said red cell antibody information, in said physical computing device, to determine a second test panel, wherein said second test panel indicates whether or not one or more laboratory tests need to be performed; and

l) outputting said in-hospital transfusion minimization care plan and said second test panel to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

60. The computer readable storage medium of claim 58, wherein said profile further comprises information regarding a health insurance plan and a health insurance provider of said subject, and

wherein said method further comprises:

comparing, in said physical computing device, a medical procedure, a laboratory test, a treatment, or a medication indicated in said patient care plan, said in-hospital transfusion minimization care plan, said first test panel, and/or said second test panel with the types of medical procedure, laboratory test, treatment, or medication allowed or restricted by said health insurance plan;

determining, in said physical computing device, whether coverage of said patient care plan, said in-hospital transfusion minimization care plan, said first test panel, and/or said second test panel requires pre-authorization by the subject'"'"'s healthcare provider;

requesting, in said physical computing device, and documenting approval of said pre-authorization by said health insurance provider; and

outputting the results of said comparing, determining, requesting, and documenting steps to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

61. The computer readable storage medium of claim 58, wherein said profile further comprises weight, gender, age, date of non-emergent surgery, information regarding whether non-emergent surgery is a redo procedure, and/or information regarding whether non-emergent surgery is a non-isolated procedure;

wherein applying said profile, in said physical computing device, to determine said level of transfusion risk comprises;

i. applying said level of hemoglobin to determine a first value, wherein if said level of hemoglobin is between 10.0 g/dL-11.4 g/dL, then said first value is two, wherein if said level of hemoglobin is above 11.4 g/dL and below 13.0 g/dL, then said first value is one, and wherein if said level of hemoglobin is more than or equal to 13.0 g/dL, then said first value is zero;

ii. applying said weight to determine a second value, wherein if said weight is less than 50 kg, the said second value is two, wherein if said weight is between 50 kg-75 kg, then said second value is one, and wherein if said weight is more than 75 kg, then said second value is zero;

iii. applying said gender to determine a third value, wherein if said gender is female, then said third value is one, and wherein if said gender is male, then said third value is zero;

iv. applying said age to determine a fourth value, wherein if said age is more than or equal to 65 years, then said fourth value is one, and wherein if said age is less than 65 years, then said fourth value is zero;

v. optionally applying said date of said non-emergent surgery to determine a fifth value, wherein if said date of said non-emergent surgery is less than two weeks away, then said fifth value is one, and wherein if said date of said non-emergent surgery is more than or equal to two weeks away, then said fifth value is zero;

vi. applying said level of creatinine to determine a sixth value, wherein if said level of creatinine is more than or equal to 2.0 mg/dL, then said sixth value is two, wherein if said level of creatinine is between 1.2 mg/dL-1.9 mg/dL, then said sixth value is one, and wherein if said level of creatinine is less than 1.2 mg/dL, then said sixth value is zero;

vii. optionally applying said information regarding whether said non-emergent surgery is a redo procedure to determine a seventh value, wherein if said non-emergent surgery is a redo procedure, then said seventh value is one, and wherein if said non-emergent surgery is not a redo procedure, then said seventh value is zero;

viii. optionally applying said information regarding whether said non-emergent surgery is a non-isolated procedure to determining an eighth value, wherein if said non-emergent surgery is a non-isolated procedure, then said eighth value is one; and

wherein if said non-emergent surgery is an isolated procedure, then said eighth value is zero; and

ix. outputting said level of transfusion risk to one or more of said computer readable medium, said server, said network, said display device, or said printed report, wherein;

if the sum of said first value to said eighth value is less than or equal to one, then said level of transfusion risk is low;

if the sum of said first value to said eighth value is two, then said level of transfusion risk is intermediate;

if the sum of said first value to said eighth value is three, then said level of transfusion risk is high; and

if the sum of said first value to said eighth value is more than three, then said level of transfusion risk is very high; and

wherein applying said profile, in said physical computing device, to determine said level of comorbidity comprises;

i. applying said information regarding current or past history of disease to determine said level of comorbidity, wherein;

if said information regarding current or past history of disease comprises past history of cardiovascular disease, cerebrovascular disease, pulmonary disease, renal disease, cancer, autoimmune disease, gastrointestinal disease, inflammatory disease, active infection, or blood clotting disorder, then said level of comorbidity comprises one or more comorbid conditions.

62. The computer readable storage medium of claim 61, wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan comprises:

i. determining whether said level of hemoglobin results in said first value being one or zero;

ii. determining whether said level of transfusion risk is low, intermediate, high, or very high;

iii. determining whether said level of comorbidity comprises one or more comorbid conditions; and

iv. selecting said patient care plan based on said level of hemoglobin, said level of transfusion risk, and said one or more comorbid conditions, wherein;

if said first value is zero, said level of transfusion risk is low or intermediate, and said one or more comorbid conditions are not present, then said patient care plan comprises one or more of oral iron or a multivitamin;

if said one or more comorbid conditions are present, then said patient care plan comprises one or more of an erythropoietic medication, intravenous iron, oral iron, desmopressin acetate, preoperative dialysis, preoperative coagulation therapy, or preoperative autologous blood donation; and

if said first value is one or said level of transfusion risk is high or very high, then said patient care plan comprises one or more of intravenous iron, cell saver, preoperative autologous blood donation, postoperative iron, or use of pediatric blood tubes for blood draws.

63. The computer readable storage medium of claim 62, wherein said profile further comprises information regarding medication taken by said subject, and

wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan further comprises:

v. applying said information regarding medication taken by said subject to determine a ninth value, wherein if said information regarding medication taken by said subject comprises one or more anticoagulant medications, then said ninth value is positive; and

vi. applying said ninth value to further determine said patient care plan, wherein if said ninth value is positive, then said patient care plan further comprises discontinuation of said one or more anticoagulant medications between about one week to about two weeks before said date of said non-emergent surgery.

64. The computer readable storage medium of claim 63, wherein applying said level of hemoglobin, said level of transfusion risk, and said level of comorbidity, in said physical computing device, to determine said patient care plan further comprises:

vii. applying said date of said non-emergent surgery to determine a tenth value, wherein if said date of said non-emergent surgery is more than one week away, then said tenth value is zero; and

viii. applying said first value and said tenth value to further determine said patient care plan, wherein if said first value is positive and said and tenth value is zero, then said patient care plan further comprises one or more of oral iron, intravenous iron, ferric carboxymaltose, iron sucrose, iron dextran, ascorbic acid, erythropoietin, folate, vitamin B12, epoetin, epoetin alfa, darbepoetin alfa, epoetin delta, PDpoetin, or methoxy polyethylene glycol-epoetin beta.

65. The computer readable storage medium of claim 58, wherein said method further comprises:

m) receiving data comprising a revised level of hemoglobin of said subject, in said physical computing device, wherein said revised level of hemoglobin is determined after said subject is treated with said patient care plan;

n) receiving data comprising a revised profile of said subject, in said physical computing device, wherein said revised profile is determined after said subject is treated with said patient care plan;

o) applying said revised level of hemoglobin and said revised profile, in said physical computing device, to determine a revised level of transfusion risk;

p) applying said revised level of hemoglobin and said revised level of transfusion risk, in said physical computing device, to determine a revised patient care plan; and

q) outputting said revised level of hemoglobin and said revised patient care plan to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

66. The computer readable storage medium of claim 65, wherein said revised profile further comprises revised weight, gender, revised age, revised date of non-emergent surgery, revised level of creatinine, revised information regarding whether non-emergent surgery is a redo procedure, and/or revised information regarding whether non-emergent surgery is a non-isolated procedure.

67. The computer readable storage medium of claim 58, wherein said profile further comprises information regarding medication taken by said subject, and

wherein applying said profile, in said physical computing device, to determine said level of bleeding risk comprises:

i. applying said information regarding current or past history of disease to determine an eleventh value, wherein if said information regarding current or past history of disease comprises past history of bleeding, then said eleventh value is positive; and

ii. applying said information regarding medication taken by said subject to determine a twelfth value, wherein;

if said information regarding medication taken by said subject comprises one or more procoagulant medications, then said twelfth value is positive; and

if one or more of said eleventh value to said twelfth value are positive, then said level of bleeding risk is high.

68. The computer readable storage medium of claim 67, wherein applying said level of bleeding risk, in said physical computing device, to determine said first test panel comprises:

i. using said eleventh value and twelfth value to determine said level of bleeding risk; and

ii. selecting said one or more laboratory tests if said level of bleeding risk is high, wherein said one or more laboratory tests are selected from the group consisting of a screening coagulation panel and a special coagulation test.

69. The computer readable storage medium of claim 58, wherein applying said level of hemoglobin and said level of creatinine, in said physical computing device, to determine said first test panel comprises:

i. applying said level of hemoglobin to determine whether said subject is anemic or whether said level of hemoglobin has been determined recently;

ii. selecting said one or more laboratory tests if said subject is anemic or if said level of hemoglobin is not recent, wherein said one or more laboratory tests are selected from the group consisting of an iron assessment panel, a complete blood count, a hemoglobin test, a vitamin B12 test, a folate test, and a C reactive protein assay;

iii. applying said level of creatinine to determine whether said level of creatinine has been determined recently; and

iv. selecting said one or more laboratory tests if said level of creatinine is not recent, wherein said one or more laboratory tests are selected from the group consisting of a creatinine test with calculated glomerular filtration rate and a blood urea nitrogen test.

70. The computer readable storage medium of claim 58, wherein applying said level of comorbidity, in said physical computing device, to determine an in-hospital transfusion minimization care plan comprises:

i. determining whether said level of comorbidity comprises one or more comorbid conditions; and

ii. selecting a transfusion product based on said level of comorbidity, wherein if said one or more comorbid conditions are present, then said transfusion product has a shelf age of less than 14 days.

71. The computer readable storage medium of claim 58, wherein applying red cell antibody information, in said physical computing device, to determine said second test panel comprises:

i. applying said red cell antibody information to determine whether one or more red cell antibodies are present; and

ii. selecting said one or more laboratory tests if said one or more red cell antibodies are present, wherein said one or more laboratory tests are selected from the group consisting of a red cell antibody identification test, a direct antiglobulin test, an indirect antiglobulin test, and a blood typing test.

72. The computer readable storage medium claim 58, wherein said method further comprises:

r) applying said information regarding current or past history of disease, in said physical computing device, to determine level of renal risk, wherein if said information regarding current or past history of disease comprises current or past history of renal disease or current or past history of diabetes, then said level of renal risk is high;

s) applying said level of renal risk, in said physical computing device, to determine a third test panel, wherein said third test panel indicates whether or not one or more laboratory tests need to be performed, and wherein if said level of renal risk is high, then said third test panel comprises one or more of a creatinine test with calculated glomerular filtration rate or a blood urea nitrogen test; and

t) outputting said third test panel to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

73. The computer readable storage medium of claim 58, wherein said method further comprises:

u) receiving data of said subject after undergoing non-emergent surgery, in said physical computing device, wherein said data of said subject after undergoing said non-emergent surgery comprises information regarding loss of blood volume during said non-emergent surgery, information regarding whether said subject had a transfusion during said non-emergent surgery, and information regarding adverse events;

v) applying said data of said subject after undergoing said non-emergent surgery, said profile, said level of transfusion risk, said level of comorbidity, said patient care plan, and said in-hospital transfusion minimization care plan, in said physical computing device, to determine a patient outcome report; and

w) outputting said patient outcome report to one or more of said computer readable medium, said server, said network, said display device, or said printed report.

74. The computer readable storage medium of claim 58, wherein said method further comprises outputting a patient satisfaction outcome report, a hospital satisfaction outcome report, an adverse event outcome report, or a surgical outcome-specific report comprising said patient care plan, said in-hospital transfusion minimization care plan, said revised patient care plan, said first test panel, said second test panel, and/or said third test panel to one or more of a computer readable medium, a server, a network, a display device, or a printed report.

76. A physical computing device, wherein said device comprises the computer readable storage medium of claim 58.