Bar Coding in Administering Medication - Case Study Example

Bar Coding in Administering Medication Bar-coding is a unique of vertical bars and spaces, which helps in easily identifying items, data etc. for smooth functioning of an organisation. This is an Automatic Identification and Data Collection (AIDC) technique. Bar-coding can be used by manufacturers of almost any item, distributors, retail stores, government agencies, hospitals and other healthcare enterprises etc. In this study we'll be analyzing the use of bar coding in health care sector. Medical errors are one of the leading causes of death and injury in America. Studies point out that about 98000 thousand people die each year of such errors in America alone. Reasons' include, prescribing wrong medicine, communication gap, oversight etc. Such a situation arises when all the intended information about the patient and the medication is not communicated to the doctors, nurses and other support staff with all clarity. Bar coding provides a reliable solution to such errors. With the help of bar code; Speed of identifying the patient, illness, prescription, past history, complications encountered etc. increases manifold. Instead of going through the lengthy papers, a bar code helps in comprehensively identifying the patient, thus helping in saving the precious time and the life of the patient. Accuracy of the data increases. Now there won't be any oversights on account of illegible writing, misprint, or Mutilated papers. The electronic medication administration record (eMAR) is one solution to provide the bed-side nurse, the doctors and all concerned a failsafe method for identifying the patient and his/ her history. General Requirement for implementing Bar-coding solution Software requirements: Operating System for the Computer System: This could include, windows operating systems Database Management System: This includes RDBMS applications like Oracle. Label design, barcode and printing software: The label can be designed with information regarding the medication being given to the patient, his medical history, his identification, lab specimen collection, verification of blood products prior to transfusion, electronic charge capture of supplies at the point of use, automated medicine dispensing system, information about doctors' and other support staff etc. Some of the typical software applications that are available in the market are1; Some notable names for Pharmacies, Clinical and MTM Software are; Clinical Support Services (CSS), MediMAR, WORx, MediCOE from Mediware Information Systems, Inc., wCareMed, wCareCollect, wBloodCare, wCareAssist, wCareView and, wCareCapture from Care Fusion. CPOE Software is available in the form of; Ambulatory EMR/ PowerChart Office, Physician Practice Solutions, Laboratory Solutions from Cerner Corporation. Inventory and Formulary software available from; Community Pharmacy, Chain Pharmacy, Institutional Pharmacy, HME, Point-of-Sale, Interactive Voice Response (IVR) from QS/1. RxAuditor service based reporting solution from Medacist Pharmacy Management Software & Pharmacy Management Technology Providers: Such comprehensive systems are provided by QS/1, PanaceaRX, AmerisourceBergen Technology Group, Retail Management Solutions, Speed Script, SRS Systems, RXLink, RS Software, AdvanceNet Health Solutions, Etreby Computer Company, Inc., Per-Se Technologies (formerly NDCHealth), PharmTrak, OPUS-ISM, McKesson Pharmacy Systems, HBS Pharmacy Services, Soft Writers, Inc., THOT Corporation, CarePoint, Inc., HCC Pharmacy Solutions, JASCORP etc. Hardware Requirements: To handle the bar coding effectively in health care sector, all the above mentioned software require adequate hardware support. For the implementation of eMAR services we need; A dependable computer/s with good amount of hard disk space, DD RAM and a latest processor fitted with the bar code reading software and other peripherals. An LCD monitor works well with such systems as it occupies lesser space and the screen in more readable. Bar Code Scanner/ imager ID Bar code printer. This printer has to be a high quality printer LAN card, network compatibility A server with storage capacity of all records, which can store records of all patients, prescriptions etc. for a period ranging from 6 months to 6 years or for the period decided by the management/ regulations Sometimes, the system is also fitted with CCTVs or webcams for the concerned to observe the patient. Palmtops fitted with the necessary warning system can also be provided to doctors, which will help them in tracking the condition of the individual while on the move. Connecting cables (preferably optical fiber cable) for networking If the networking is done through mechanism like wi-fi, then we need towers, transmitters and repeaters to carry the signals Networking for eMAR The health care professionals, the patient, some of the relatives of the patient and in some cases, the researchers as well, need to remain constantly updated about the prescription and medical health of the individual. This will help the medical professionals attached with the individual in following the medical conditions and taking quick course of correction whenever need arises. At times the medical fraternity prefers to analyse certain medical cases for the purposes of research in a newer field, therefore such info is often passed on to the researchers. Networking will link the eMAR system with all the concerned departments within the system like medical, pharmaceutical, financial, OEC, CPOE etc. Networking can in general be of two types for a project like eMAR; Local Area Networking (LAN): Such a networking proves to be helpful if the networking is to be done in a limited area like a hospital building, research institute, office complex etc. This requires cables to be laid out all over the place in a systematic and well planned manner. A drawing of the routing etc. must be available with the system administrator, to facilitate debugging. Wide Area Networking: This type of networking proves helpful when the patient is shifted from one hospital to another or one place to another. The bar coded RF tag can be fitted in the armband of the patient and his/her condition can be monitored at more than one location by the concerned doctors. This way, a doctor who's just started attending to the patient can converse with the previous doctor and seek his guidance in carrying out further diagnosis/ medication. Scalability, Usability and Functionality Scalability: The software or hardware that is being used for one set of patients in one building or in one organisation must be able to handle growing amount of work in equally efficient manner. The existing system if required to be upgraded to include more features must be able to sustain the newer demands without any damage or loss of existing database Usability: The system must be user friendly, with interactive features. Usability refers to the clarity with which the medical practitioners can login to the system, interact with the computer system to get updated results, or can discuss the issues with other experts. The system must be secure enough not to allow unwanted individuals an access to the system. A reasonably usable system must be able to; ensure the rights of patient safety at the bedside, view of original CPOE and view the historic alerts Functionality: The salient features of a software system determine its functionality. The eMAR is only as good as the drug database that supports it. Therefore the system's functionality will determine how well the system can integrate with the database and accept inputs from various sources. Inputs from different ends will become part of the database only after due verification. Functionality also determines in what form the information is presented to the user. In general the eMAR system should have multiple access points to enable all authorized users to zero in on Data-Bank drug information quickly and efficiently within their normal workflow. Functionality also facilitates communication between pharmacy and nurses Some of the Possible Residual Stimuli of eMAR Project: At times previous experiences, previous results result in affecting the present situation and present outcomes from the system. This is called residual stimuli i.e. the stimulant from past, previous experiences, which forms part of the system. For the eMAR project, some of the residual stimuli could be; Doctor's experience with some earlier version of the system Nurses and other support staff's reluctance in using the system on account of some apprehensions The fear of being out of job for the laboratory and documentation staff. Such fears arise with the talk of implementation of an automation system Fear of technology. Some old hats who are not well conversant with the latest in technology are apprehensive about its use. Read More