Electronic identification systems in transfusion safety: a narrative review of effectiveness and cost-effectiveness evidence

Background: Transfusion safety is fundamental to patient care, yet misidentification and clerical errors persist as significant risks. Electronic identification systems, such as barcoding, radiofrequency identification (RFID), and integrated transfusion management platforms, have been adopted to enhance verification, traceability, and safety. While their clinical benefits are well documented, cost-effectiveness remains a crucial factor, particularly in resource-limited settings. This review examines the effectiveness of electronic identification systems in improving transfusion safety and evaluates their economic viability across various healthcare environments.

Methods: Literature searches were conducted in PubMed and Scopus, supplemented by reports from the World Health Organisation (WHO) and the Association for the Advancement of Blood & Biotherapies (AABB). Publications from 2015 to 2025 were screened for relevance to transfusion safety, error reduction, patient outcomes, and economic evaluation. A narrative synthesis approach was used to integrate findings from both high-income and low-resource settings.

Results: Electronic identification systems consistently reduced the incidence of wrong-blood transfusions, near-miss events, and mislabelling errors. Barcoding improved bedside verification, while RFID enabled real-time tracking of blood products. Cost-effectiveness analyses demonstrated that, despite significant initial investment, long-term savings were achieved through fewer adverse events, reduced litigation costs, and enhanced workflow efficiency. Evidence from high-income countries supports widespread adoption, whereas studies in low- and middle-income settings highlight challenges related to infrastructure, training, and sustainability.

Conclusion: Electronic identification systems enhance transfusion safety and demonstrate favourable cost-effectiveness over time. Their integration into routine practice aligns with international recommendations for patient safety.

Clinical Significance: Electronic identification systems reduce preventable errors and increase efficiency, thereby strengthening patient safety and healthcare quality. Developing scalable and sustainable models for resource-limited settings is essential to ensure equitable access and maximise global impact.

© 2026, Moses Dabah Lugos. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.