Jerry Fahrni

Tag: Barcoding

  • More problematic barcodes

    Recently I’ve heard of hospitals having problems with barcodes on pre-mixed IV bags. The problem isn’t related to the legibility or quality of the barcodes, but rather the location and/or the information contained within the barcode itself.
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  • Standardized Numerical Identifiers (SNIs), say what?

    A couple of weeks ago a friend and colleague shot me an email asking me if I’d heard about the new “pedigree stuff on barcoding”. I consider myself pretty well informed for the most part, but I had no idea what she was talking about. Upon further inquiry she sent me a PDF document titled “Guidance for Industry Standards for Securing the Drug Supply Chain – Standardized Numerical Identification for Prescription Drug Packages” (the SNI document). The document is also available in non-PDA format at the FDA website here. I asked other pharmacists about the SNI document while at the Siemens West Coast User Group Meeting on September 16, but no one had a clue what I was talking about; not event the Siemens product manager that was in attendance.
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  • Laser etched bar-code may help curb counterfeit drugs, among other uses

    One Nucleus: “The technique will allow faster identification and resolution of any manufacturing quality problems but will also prove invaluable as an anti-counterfeit measure because the specific coding and validation systems are almost impossible to copy.

    Currently most components within diagnostic kits, medical devices and other healthcare products and equipment are ‘stamped’ with a lot code at the point of manufacture. However, these codes are of limited use for quality improvement unless products are produced in very small batches. As a result, regulatory bodies across the world are now putting manufacturers under increasing pressure to invest in much more sophisticated traceability systems, while manufacturers are looking for effective ways to prevent the growing problem of counterfeiting of pharmaceuticals and other healthcare products.

    The breakthrough approaches being developed by Innomech will enable manufacturers to mark products with a code that is either unique to the item or shared by only a small number of items produced together.

    The codemark is an unobtrusive two-dimensional dot matrix identifier that is linked to a look-up database. In effect the matrix code acts as a ‘key’ to access much more detailed information, such as the specific batch codes of raw materials used during production, the time of manufacture, the production line and so on. A version of the database could be accessible online for anyone to verify the item is genuine.

    The codes can be printed or laser etched onto products, applied to virtually any substrate and can even be added onto the surface of pharmaceutical capsules or coated tablets. Matrix codes can be as small as 2 mm by 2 mm holding the code for up to 10 billion numbers. The codes can be read by widely available readers or in many cases from a picture taken with even the simplest camera phone, making them ideal in the battle against counterfeit medicines.”

    This is an interesting approach to an age old problem. I wonder if this technology could be used to embed drug information directly on the medication as well, an idea that I hijacked from the Nursetopia website where Joni Watson muses that “Both companies and pharmacies could add a QR code/Microsoft Tag to the medication label for patients and/or healthcare professionals to scan and directly access the patient medication information sheet.” Why not put the QR code directly on the medication itself? Why not indeed.

  • “What’d I miss?” – Week of June 13, 2010

    As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
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  • Update from day two at the unSUMMIT

    Today was the first full day of unSUMMIT activity and I found myself picking up quite a bit of useful information. I didn’t attend every session, but managed to make the most of the ones I did. Even though the conference is billed as bedside barcoding I found that many of the presentations went beyond barcoding to include clinical decision support, techniques for education, troubleshooting tips and tips on how to best create a multi-disciplinary team for project planning and implementation. 
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  • Headed for the unSUMMIT (#unSUM10)

    I’m sitting in the airport waiting to board my flight for Atlanta to attend the unSUMMIT. This will be my first time attending the unSUMMIT and I’m getting pretty excited about it; like I get before every conference I attend.

    The unSUMMIT is billed as a place to get information on barcode point-of-care technology (BPOC), also known as barcode medication administration (BCMA). The promotional material for the unSUMMIT states that “attendees are outfitted with practical tools, insight, and inspiration for leading their institutions to carefully select, implement, and harness the quality-improvement power of BPOC systems.”. I could benefit from that.

    Our facility uses barcoding technology in the pharmacy and recently went live on the floor with BCMA. Some of my thoughts on the implementation can be found here. However, the work doesn’t stop after implementation; in fact the workload has increased since going live.

    Barcoding technology has been around for a couple of decades, but its use in healthcare is still in its infancy. The scope of barcoding goes beyond patient safety, which has been called into question by some, to encompass inventory tracking and management, medication usage and real-time medication administration data for pharmacists. It’s hard to say whether the technology will ever be the magic bullet everyone wants it to be, but it deserves the same attention we give all technologies that have potential to impact patient care, positively or negatively.

    I’m looking forward to hearing the closing keynote by Barbara Olson; Twitterer (@SafetyNurse) , blogger and director of patient safety at HCA. Some other items of interest include the following sessions:

    – “Alert, Alert, Alert! Effective Layering of Clinical Decision Support Tools of a Hospital’s Medication Delivery System”

    – “Alternatives to Barcodes in Medication Administration – RFID and RTLS”

    – “Optimizing Patient Safety Utilizing BPOC Metrics”

    – “Intravenous Interoperability: Combining Intelligent Infusion, BPOC, and eMAR”

    – “Observation-Based Medication-Error Detection”

    – “It’s Not “Sophie’s Choice”: Creating and Sustaining Work Processes That Enhance Medication Safety at the Point of Care.”

    The entire list of  unSUMMIT conference sessions can be found here.

    To keep everyone up to date on what’s going on I will be using the 140 character gorilla of social media, i.e. Twitter, while at the unSUMMIT along with Susan Carr and Barbara Olson. I’ll be there all week so feel free to follow the action using #unSUM10. Should be a real hoot.

  • Cool Technology for Pharmacy – CHS 7X

    Bar-Code Point-Of-Care (BPOC), also known as Bar-Code Medication Administration (BCMA) has been a hot topic in health care for a while now. Some people love it while others hate it. Regardless of how you feel about bar-coding it is here to stay for a while and the technology, both hardware and software, is pretty cool.
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  • Cool Technology for Pharmacy

    In a previous post I mused about using an automated packaging system like InSite from Talyst as a type of automated dispensing cabinet for acute care patients. InSite was designed for long-term care and would simply be too large for the needs of an acute care nursing unit, but the technology is ideal.

    However, the ATP-71 (PDF) from Swisslog is a bulk packager that can hold up to 71 canisters in a relatively small footprint: 31.5 inches wide x 29.6 inches deep x 30.6 inches high. For comparison, a Pyxis MedStation 4000 2-drawer main unit is 22.8 inches wide x 26.7 inches deep x 27.7 inches high. I would say that makes the two units comparable in terms of size, and I can tell you from personal experience that a 2-drawer main isn’t very big up close.
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  • Quick hit – Barcode scanner consistency

    Part of the process of implementing barcode medication administration (BCMA) is evaluating hardware; mostly scanners. There are several makers of barcode scanners including Honeywell, Symbol, Metrologic, Datalogic and Code Corp. Having so many choices always makes the selection process interesting.

    One suggestion from several hospitals I spoke with that were already live with BCMA, was to use the same barcode scanner on the nursing floors that were used in the pharmacy. That sounds logical, right? Sure, if the barcode scans correctly in the pharmacy, then nursing should be able to scan the same barcode using the same scanner.

    The scanner of choice in our pharmacy department is the the Code Reader 3500 from Code Corp. So of course this is the scanner I recommended in my report to the BCMA hardware sub-committee. For whatever reason, the committee decided to go with a different brand of scanner. Unfortunately the scanners we purchased won’t scan some of the more complex barcodes coming out of pharmacy, making them virtually useless. The scanners purchased by the hospital are on their way back to the wholesaler as I patiently await for round two.

    Take away lesson: use the same barcode scanner for the nursing units that the pharmacy department uses to meet their barcoding needs.

  • Barcode scanner dilemma

    barcode_scanAs barcoding in pharmacies grows in popularity I get exposed to more and more barcoding equipment; particularly barcode scanners. Our carousels utilize barcode scanners from Code Corp, our AutoPack system utilizes a barcode scanner from Honeywell – previously Handheld – and our barcode medication administration system will use a yet-to-be-determined scanner. In addition, I’ve accumulated a nice collection of various scanners in my office including wireless, Bluetooth and tethered.
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