Widespread use of bar-coding is seen as inevitable

Athough moving at a glacial pace, widespread implementation of bedside bar-code medication administration is inevitable, according to industry analysts. They base that prediction on three factors:

"Virtually everyone is gearing up for it," said Mark Neuenschwander, president of The Neuenschwander Co., technology consultants in Bellevue, Wash. "By most accounts, the best-of-breed vendors are reporting a significant increase in orders for bedside scanning [technology]."

The number of hospitals implementing what the Healthcare Information and Management Systems Society (HIMSS) calls "bar-code-enabled point of care" (BPOC) remains small, however. Neuenschwander estimates that only about 5% of the nation's approximately 4,900 community hospitals have implemented the technology. One reason is that the drug manufacturers are only now beginning to mark their products with bar codes. Another is cost: Bar-coding might cost less than CPOE, but it isn't inexpensive.

"Bar-code technology complements other valuable technology, such as electronic medical records," said Michael Wisz, VP of product management for Bridge Medical, a best-of-breed manufacturer. In June, Bridge signed an agreement to be purchased by Cerner Corp., another manufacturer of integrated patient-safety products. "And many of the incremental purchases in this technology are usable by other applications, such as wristbands, for a range of services," he said.

In addition to the fact that new FDA and JCAHO requirements make BPOC a good idea, it's a solid business decision, say analysts. According to an HIMSS report titled "Implementation Guide for the Use of Bar-Code Technology in Healthcare," bar-coding helps avert costs associated with medication, blood transfusion, and laboratory specimen collection errors.

The average cost of a harmful medication error is $4,600, according to HIMSS, and the average amount of a medication error malpractice award is between $363,000 and $668,000. When the FDA proposed the bar-code rule in 2003, the agency estimated the average direct cost of an adverse drug event at $2,257 and ADEs at 28.4 a year, on average, for each hospital. "If each harmful medication error costs $4,600, bar-coding at the bedside may avert millions of dollars in losses each year," according to HIMSS.

"Many elements are coming together to make this technology a powerful force in patient safety," said Mary Beth Navarra, R.N., VP and patient safety officer for McKesson Provider Technologies, another leading manufacturer of integrated bar-code technology. "The ability to verify in real time the appropriateness of a medication at bedside is now seen as a potentially invaluable technology."

In fact, BPOC is just one element of the possible value of bar-coding, said Keith Scheckelhoff, McKesson's VP for medication safety solutions. "The FDA mandate helps in many ways, but it affects only unit doses," he said. "The value of bar-code technology lies also in its ability to help manage inventory and help pharmacists accurately fill prescriptions."