A significant number of adverse drug events (ADEs) in South African hospitals every year can be attributed to human error, which is why the adoption of barcode technology has become so critical.
According to the World Health Organisation (WHO), more than 50% of all countries do not implement basic policies to promote rational use of medicines and in developing countries, less than 40% of patients in the public sector and 30% in the private sector are treated according to clinical guidelines.1
Safe medication administration is underpinned by the principle of the "Five Rights" - right medication, right dose, right time, right patient and right route. When implemented properly, barcode solutions can significantly improve the success rate of this process and enhance patient care at the bedside.
With the benefits of new technologies and tools aimed at improving healthcare having come under the spotlight at the South African Medical Device Industry Association [SAMED] and Health Africa conferences held in Gauteng last month, there is merit in exploring how patient barcode solutions are taking medical technology to the next level.
Of all the medical technologies being developed, barcode solutions have climbed to the top of industry list due to their relative ease of implementation, demonstrated return on investment (ROI) and broad array of applications.
Simply put, barcode technology eliminates the need for traditional keyboard data entry. It requires conversion of an identifier to a symbolic representation namely, the barcode.
The barcode can then be printed on or affixed to an item and subsequently read by a light source and fed into a computer.
Barcode solutions can be used in a variety of healthcare applications, including producing hospital wristbands and labelling for pharmaceutical unit-dose medications, IV mixtures, lab and pathology specimens, blood products, asset tags, file labels and more.
Pharmaceutical companies can locate and track each dose of medication produced in vast batches; hospitals can monitor and utilise equipment with greater efficiency; and healthcare staff can create and maintain healthcare records more efficiently.
The rate of accuracy at which information can be captured is exceptional. Barcode scanning equipment is much faster than the human eye and notably more accurate. When tested, barcode scanners were proven to have an accuracy rate of one error per 10,000,000 characters. By comparison, keyboard entry error rates of one error per 100 characters were noted.
In short, the benefits of patient barcode solutions or Barcoding Point of Care (BPOC) systems can be summed up as follows:
• They eliminate the chance for errors in recording data with the added benefit of doing so in a fraction of the time required for manual entry
• They are easy to use. Unskilled operators can learn and operate the equipment in a fairly short time.
• Standardised codes and finely honed technology mean the likelihood of barcode equipment purchased this year being obsolete next year is not high.
Because it is important for cash conscious hospitals to carefully investigate the long-term benefits of any new technology, the use of patient barcode technologies in hospitals has been modest. Like most electronic technologies, however, unit costs have been reduced dramatically over the past few years and the uptake is expected to increase exponentially.
The Food and Drug Administration (FDA) in the US estimates that purchasing barcoding equipment and training staff on the technology will cost about $53.1mi, but will result in 413,000 fewer ADEs over the next 20 years and will avoid related hospital stays, saving an estimated $41.4bn. In South Africa, this would translate into a cost of about R556m and an estimated saving of R431.5bn.
While the initial investment may sting a little, the long term benefits and ROI (clinical and measurable financial) far exceed any investment capital required. Studies conducted abroad have proven that the results of implementing such systems include notably fewer adverse drug events, avoidance of related hospital stays and marked savings on hospital bills.
Importantly, hospitals are expected to avoid litigation associated with preventable adverse events reducing malpractice liability insurance premiums, and increase receipts from more accurate billing procedures (in excess of the barcode implementation and maintenance costs, according to the FDA).
Hospitals also benefit from the marketing and patient preference benefits associated with quality care and industry leadership in the adoption of new technologies and clinical processes. Less obvious, but of equal importance, are the collateral benefits of barcoding to nursing and pharmacist productivity, charge capture, inventory management, asset utilisation, commodity tracing and tracking, and the market value of patient safety leadership.
In the United States the FDA mandated that pharmaceutical manufacturer's barcode their products at the unit-dose level. The benefits that emanate from this include patient safety, brand protection and fraud detection, supply chain, and return and recall processes.
Ultimately, the factor that emerges as most important is, of course, the vast improvement in the quality of patient care and improved efficiency that leads to delivering better service and reducing costs.
