65.5 F
San Diego
Monday, Mar 18, 2024
-Advertisement-

Drug Bar Codes Check Into Hospitals

Drug Bar Codes Check Into Hospitals

Health Care: Computerized Program Watches for Administering Errors

BY MARION WEBB

Staff Writer

Drug makers and some health care providers say a government proposal to require supermarket-style bar codes on all prescription drugs to reduce deadly medication errors will be costly, technically challenging and will face resistance from hospital staff members.

Yet Dr. Robert Smith, associate chief of staff at the Veterans Affairs San Diego Healthcare System barcode medication administration, said the decision by the VA to adopt high-tech solutions to ensure a patient’s safety has already paid off.

Since the 240-bed facility in San Diego started tracing the handling of medications , from the doctor’s order to the pharmacy, to the nurse at the bedside , inpatient medication errors have dropped 50 percent, he said.

Pressure to make improvements in the handling of medications comes from the government, patient advocates, even the hospital-supported agency that accredits hospitals after a 1999 Institute of Medicine report on hospital errors.

During a Dec. 3 meeting of the American Society of Health-Systems Pharmacists, Assistant U.S. Health Secretary Bobby Jindal said bar codes should be required on all hospital-administered prescription drugs to ensure patients’ safety.

Statistics show between 48,000 and 98,000 Americans die each year from medication errors, putting the economic total at hundreds of millions of dollars, Jindal said.

Russell Lewis, COO at Solana Beach-based Bridge Medical, Inc., which has developed a medication bar-code software program, said human errors remain a sad reality in the medication management process.

“Hospitals have been a culture of blame and individual negligence, and errors are built into the system,” Lewis said.

Mistakes can happen at various steps along the long drug-handling route: Doctors may write an inappropriate order, transcribers may misinterpret it, pharmacists may dispense the wrong drug and nurses may give it to unsuspecting patients.

Bar coding systems that scan the patient’s wristband, the nurse’s ID badge and the medication matches them with a computerized list to check for things like correct dosage, allergies, drug-interactions, the appropriateness of the drug, and even times of administration, Smith said.

If something appears questionable, the system flashes an alert or asks the nurse to take action.

The VA San Diego has invested more than $10 million to install its system, which comprises some 60 wireless PCs on carts that cost between $6,000 and $10,000 a piece, Smith said.

Every nursing station has two to four carts for nurses to push into a patient’s room to dispense medication.

In addition, VA San Diego spent big bucks to build their own “re-labeling plant” in order to provide consistent bar coding on all medications, Smith said.

Lewis said today only about 35 percent of all medications are bar coded, and drug makers aren’t likely to endorse bar coding as long as there is no agreement on a standard.

Making changes in the manufacturing process is also potentially costly for companies, raising the barrier for endorsement, Lewis said.

Smith said the VA’s vision to build a sophisticated network linking its 160 hospitals took seven years to realize. He said commercial vendors didn’t offer an equivalent product, so the government agency took it upon itself to build it.

Others hope to imitiate their success.

UCSD said it is on its way to adopt a similar system at its two hospitals , the UCSD Medical Center in Hillcrest and Thornton Hospital in La Jolla.

Gordon McGuire, senior pharmacist for the UCSD hospitals, said he’s excited about the promise of computerized medication handling in spite of the large cost.

McGuire said the millions of dollars it will cost UCSD to implement such a system will help reduce harmful medical errors and save time and money spent in additional hospitalization and safeguard from legal disputes.

He hopes by this time next year, both hospitals will have both a bar coding system and a physician order-entry system up and running.

McGuire admits some people don’t share his excitement.

For harried doctors and nurses, the system means getting used to a whole new routine.

“Most nurses like to come to the bedside with a medicine cup,” he said.

Bar coding takes more time, requiring the nurse to scan and unwrap every single pill at the bedside, before verifying it on the computer.

Smith said at the VA, a small number of patients have said they are worried about people finding out they need drugs for illnesses they don’t want them to know about.

And some doctors don’t want to order drugs on a computer, which takes longer than writing a note. “People have said that they didn’t go to medical school to be a typist,” Smith said.

Still, the recent statistics on reduced medication errors is winning some critics over. There seems to be less confusion on illegible handwriting, drugs with similar names and misinterpreted abbreviations, Smith said.

For others, the big investment remains a stifling factor. Kaiser Permanente, one of the nation’s largest HMOs, is among them.

“The Kaiser Permanente program is so large that it would cost many millions of dollars to (implement a bar coding system),” said Sylvia Wallace, a Kaiser spokeswoman in San Diego.

-Advertisement-

Featured Articles

-Advertisement-
-Advertisement-

Related Articles

-Advertisement-
-Advertisement-
-Advertisement-