When three infants died in September after receiving an adult dose of heparin at an Indianapolis hospital, patient safety experts pointed to the absence of bedside bar-coding-a technology they claim could have prevented the tragedy.
Of the more than 5,700 hospitals in the United States, just over 500 have bar-code systems in place. And while powerful forces from the Food & Drug Administration to the Joint Commission on Accreditation of Healthcare Organizations have been pushing for widespread adoption of bar-coding at the bedside, cost factors and other obstacles have kept this technology still prohibitive for many hospitals. But as the spotlight on patient safety grows and bar-code integration becomes less arduous, health systems are pursuing this technology in spite of existing barriers.
Jane Phillips Medical Center, a 144-bed hospital in Bartlesville, Okla., was looking for a bar-code solution that not only prevented med errors but also beefed up reporting capabilities and the detection of errors. "There are plenty of reasons to go with bar-coding, and no good reasons why you shouldn't," said Marc Rafferty, Pharm.D., pharmacy manager at Jane Phillips.
Rafferty explained that the decision to pursue bar-coding at this juncture was based on a combination of factors, most notably the ability to curtail med errors and save money. Citing figures that placed the cost per adverse drug event (ADE) at $4,685, the hospital weighed that cost against the cost of implementing a bar-code solution.
"It was a clear win for us. The cost of ADEs far outweighed the cost of implementing bar-coding," Rafferty said. And while the cost of implementing bar-coding can be a strain on a budget, hospitals can keep their costs low by scaling down the system to meet their needs. "We have found you can scale a solution to your facility size. You can get this safety technology to the patient and start preventing errors and really not spend those dollars that you sometimes see quoted. We were able to do that and not break the bank," he said.
Vendors, too, are beginning to address the cost-prohibitive reputation that bar-code technology has, and some are taking steps to remove the negative perceptions. "We are participating in the process of helping this technology to mature and become easier to install, easier to use, and more affordable," said Dave Swenson, R.Ph., COO for IntelliDOT.
Making a dent in the small but competitive marketplace isn't easy for bar-code vendors that are looking to carve out a niche. While Meditech, McKesson, Siemens, and Cerner Bridge Medical have the lion's share of the market, IntelliDOT recently got a boost when it signed an agreement with Health Management Associates to provide bedside bar-code medication administration management to 55 HMA hospitals nationwide and with group purchasing organization AmeriNet's 2,100-member hospitals. Those deals place IntelliDOT in the top tier of bar-code vendors.
For hospitals, reducing the number of ADEs and medication errors remains both a financial and logistical challenge that requires multidisciplinary cooperation. Rafferty believes that pharmacists should be playing a dominant role in patient safety initiatives. "Hospital pharmacists should take the lead role in medication management issues. That's our expertise; that's the angle that we come from."