Barcode technology has been around for decades, and it continues to grow in its use across many industries such as retail, transportation, logistics, public security, automated production, healthcare and more. Barcodes have become very mission critical to countless organizations. In healthcare, it’s even been argued barcodes have actually helped save lives by reducing human error in medication administration. So, how does a healthcare practice go about adopting barcode technology? There are many factors to consider, from the team that will use it to the hardware, and more. The actual barcode image itself is a big consideration.
Healthcare IT News recently referenced a report stating that processing prescriptions through computerized provider order entry can cut drug errors in half, and could avoid more than 17 million adverse incidents annually. According to a post on the U.S. Food and Drug Administration (FDA) website, it’s been reported that in hospitals alone more than 7,000 deaths each year are related to medications. So, the FDA proposed a rule requiring bar codes on certain drug and biological product labels. This was to make sure drug dosage and administration were more accurately administered to the right patients at the appropriate time. As a result, today medication dispensing largely relies on Barcoded Medication Administration (BCMA) systems.
According to an article published in the New England Journal of Medicine, barcode technology is helping a lot. The article reported about a study of error rates in medication administration comparing before and after barcode technology was used. The use of barcode technology provided a 41.4 percent relative reduction in errors.
DESIGN OBJECTIVES AND CHALLENGES
There are quite a number of professional off-the-shelf BCMA system options on the market. But, in a lot of cases, healthcare facilities consider developing their own barcode solution. This way they can tailor it to specific requirements for their practice. However, barcode reader technology can be complex to implement. This is why even BCMA system providers often rely on third party barcode reader technology providers to acquire the technology. It can really defocus an organization short term and long term just to develop a barcode reader as part of a complete BCMA system. There are short term immense development time and costs that can come with it. Long term there are technical support staff, time and costs issues that can mount.
1D barcodes continue to be widely used in hospitals for basic goals such as identifying medications or prices. However, healthcare organizations are also using 2D barcodes to achieve more mobility and because they can store even more data. Compared with linear 1D barcodes, 2D barcodes have the advantage of more memory capacity. They can store more information types within less barcode space. So, a starting point might be considering whether 1D is enough or if your organization and workflow demand 2D barcodes. But, it’s important to try and anticipate future needs as far as 1-2 years out.
The quality of the barcode image, with a recommended resolution of 300 dpi (dots per inch), is also important for better accuracy of barcode recognition. Lowering quality to save storage or download time can disrupt data acquisition or workflow. As an aside, it’s also a good idea to allow capabilities to manually verify and correct scanned barcode data when errors are found.
These design challenges and objectives of creating or adopting a BCMA system are just the tip of the iceberg.
BCMA SYSTEM IN ACTION
A typical healthcare organization scenario might be one where medical records are held in a client/server database-based BCMA system. This system might allow users to manage many aspects of a patient, from insurance and other administrative tasks to x-rays and, of course, medications. It is here that a medication administration workflow should begin. A healthcare provider would make an entry detailing a patient’s medication orders. With proper networking in place the entry can subsequently appear in related software points, such as the pharmacy’s software.
Medications can be barcode scanned to populate relevant data into the BCMA system. With the data captured, it can be shared with pharmacists to process medication orders, nurses to properly administer medication, and more. BCMA system can display key information: to whom, what, when and how much medication is to be administered.
The software can be used also to verify action was taken. For example, it might be used to ensure the correct medication was ordered, that it was administered, that the proper dose was used, and more. Reports might even be generated to document medication administration procedures.
HUMAN FACTOR CONSIDERATIONS
Often, healthcare providers might use multiple methods for documenting medication administration. For example, there might be a paper trail combined with a BCMA system. While the intent for dual documentation may be well intended, the duplicated effort may also contribute to medication administration errors. It’s also very likely to reduce staff productivity. This is why ensuring the adoption of a good BCMA system based on excellent barcode technology is so important. With it staff are more confident in relying on a single system for medication administration. It can help with all tasks, from barcode scanning medications to populate the information to tracking and monitoring medication administration.
A BCMA system can be used to audit and check for proper medication administration. But, it’s important to consider it not be used as a way to document inaction or improper administration for punishment. The last thing any staff wants to do is use a system that might be used against them. So, take advantage of a BCMA system’s ability to verify proper administration in a way that positively reinforces its use and reliance with staff.
GET GOING WITH BARCODE TECHNOLOGY
As is the case with almost any software development or adoption, analysis and testing of the application is also important. It will be helpful to get input from the various departments that might be involved in using your BCMA system: from doctors and nurses to pharmacies and accounting. Their involvement should include pre and post development or adoption of the solution. In addition to staff, don’t forget the hardware and software platforms you use. You need to ensure the barcode technology can work across workstations, browsers, flatbed scanners, webcams, and more. You need to ensure your barcode scanner devices are able to read the barcode images and that data is properly captured into your BCMA system.
If you’re planning to do build one in-house or if you’re a BCMA system provider, consider taking advantage of as many software development kits (SDK) as possible. They will help reduce costs, save you time, and save you headaches. For example, Dynamsoft’s document imaging and barcode reader SDKs are specifically designed for use in applications such as healthcare. The imaging SDKs can help with just about any document capture requirements. The barcode reader SDK can fulfill barcode reader technology needs. The SDKs can each turn months or year-long projects into just days. Up-front costs are nominal compared to building the solution yourself and more often than not, SDKs will be loaded with features beyond your scope of needs.
Don’t forget too that a good SDK provider supports their solution expeditiously and for the long run. To ensure this, you must research SDKs and their providers to ensure they deliver the features, customization and technical support levels you require. This evaluation of SDKs to compare buy-versus-build scenarios is a great place to get started.
- Barcode Medication Administration: Lessons Learned from an Intensive Care Unit Implementation. By Mary V. Wideman, Michael E. Whittler, Timothy M. Anderson
- Workarounds to Barcode Medication Administration Systems: Their Occurrences, Causes, and Threats to Patient Safety. By Ross Koppel, PhD, , Tosha Wetterneck, MD, MS, Joel Leon Telles, PhD, and Ben-Tzion Karsh, PhD
- Strategies to Reduce Medication Errors: Working to Improve Medication Safety, FDA
- GS1 on Wikipedia