The adoption of barcoding in the health system has brought massive benefits to both healthcare facilities and patients alike. Studies reveal a reduction of 82% in error in medication administration, 90 000 fewer serious medical errors each year and 20% reduced mortality rate. That’s right – barcodes can save lives!By Cat Robinson
Barcodes are used in a huge variety of medical applications; including drug and medication identification and management, blood and specimen control and safety, patient identification, the tracking of medical equipment, and sterilisation of surgical equipment to name a few. In addition they are also a powerful tool against the sale of expired or counterfeited drugs. In 2004, the FDA (US Food & Drug Administration) ruled that barcodes must appear on certain human medications, and must be readable by linear barcode scanners. The barcode number used is a 10 digit National Drug Code (NDC), which contains the name of the medication, the pharmaceutical company which produced the drug, and the recommended dosage. Additionally these barcodes may also include the expiration date and lot or batch number of the medicine in question.
Origin and Barcode Symbologies:
The idea of barcoding in the medical field dates back to 1984 in the USA and 1987 in Europe, and is known as the HIBC (Health Industry Bar Code). Because the barcode needs to be compact and contain a relatively large amount of data, Code 39 was recommended initially and is still used today. However, because Code 128 offers a higher density code, it is now often utilised where a limited amount of space is available. On very tiny items, the 2-dimensional version of Code 128 – known as Codablock F – may be used. You can read up on more barcode symbologies in our earlier blog post. Within this code both a primary and secondary code are used. The LIC (Labeller Identification Code) and PCN (Product Code Number) comprise the primary code. This includes the identifier for the origin of the label and the manufacturer and type of product. The secondary code includes tracking information such as serial number and expiration date, and optionally also quantity references.
Blood and specimen management:
In the case of blood transfusions and specimen collection, the FDA requires blood and blood components to carry barcode labels which are comprised of a unique identifier of the facility where the blood originates from, a product code, blood type and lot number which identifies the donor of the blood. Because barcoding helps to greatly alleviate error in the tracking and management of specimens used to diagnose disease, they create a much safer testing and diagnostic procedure, helping to alleviate inappropriate or delayed treatment or incorrect adjustments in medication.
Patient identification and validation:
The ability of nurses to scan both medication barcodes and the patient’s ID wristband barcode against each other can greatly reduce the chances of a patient receiving the incorrect medication or dosage, as well as tracking the patient’s medical records and visit history. Information such as specimen collection, infusions and medication management can all be monitored directly at the point of care, reducing the chance of medical errors and even fatalities.
Inventory tracking and surgical instrument identification:
Having barcodes appear on surgical items has multiple benefits for hospitals and surgeons. Not only can inventory be monitored – such as before and after a surgery to ensure no small items may have been left within the patient’s body after a large surgery, but also to ensure all items have been sterilised prior to and after surgery. Because many surgeons have preferences as to which instruments they use in their personal kits, hospitals can also save money by avoiding the purchase of expensive instruments which may never be used.
Barcodes to prevent the use of fake or counterfeit medication:
Linear barcodes allow a certain amount of data regarding the medication concerned to be monitored and traced. However, after it was discovered in February of 2012 that counterfeit cancer infusion drugs had found their way into hospitals in the United States, the FDA may require additional information including a unique serial number and lot number for each item to be shown as well. This means that 2D barcodes (GS1 DataMatrix is a likely option) will be required to contain all this additional data without creating an inhibitively large barcode. Looking towards the future, it is likely that RFID tags will become the safest option to combat fake and potentially lethal medications from entering the healthcare chain, although adoption, especially in the developing world, will take many years still.
Our blog researchers include local barcode experts from the SA Barcodes team: Cat Robinson and Andreas van Wyk
SA Barcodes Team
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