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Barcoding at the Point-of-Care

February 3, 2011
by John DeGaspari
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The next step in medication administration to close the loop

I recently had an opportunity to speak with Mark Neuenschwander, an expert in drug dispensing automation and an advocate for the use of barcode point-of-care systems in hospitals. His goal, he says, is to “get the nation collectively off the dime and to do barcoding at all points-of-care all of the time.”

Neuenschwander estimates that about 35 percent of hospitals in the U.S. now scan medications at the point-of-care, where medications are administered. In 2001, only 3 percent of hospitals used barcoding at the point-of-care to administer medications to patients, he says.

He maintains that the number of hospitals that use barcodes for transfusions and for tracking specimens at less than a third. And, he adds, in the case of specimen tracking, barcode use may be limited to inside the laboratory, but it not necessarily used to scan the patient at the bedside, he says.

That’s a significant number of hospitals, but still leaves a lot of ground to cover.

In Neuenschwander’s view, barcoding at the point-of-care is low-hanging fruit when it comes to preventing medication errors. “It’s the safety net at the final point when medications are given, where the process is the most vulnerable,” he says. He notes that seven of the 15 measures on meaningful use include medication reporting in the electronic medical record. But he also notes that it’s possible to have an electronic record without using barcoding at the point-of-care.

The next step in medication administration, he says, is to barcode at the point-of-care, and feed the information, in real time, into the patient’s record “without any gaps in between, where errors can occur.” He is hopeful that the terms “barcoding” and “closed-loop”—referring to closing the entire medication administration process loop with technology—will be included in future rounds of meaningful use.




Bar-coding at the point of 'transaction' is a nice, but error prone, first step. There are too many dependencies. Although the technology is stable, it is also getting stale. The technology should instead be moving toward biometrics. Positive identification, in theory, is less error prone and resources should be allocated to this paradigm. It is likely that real-time DNA identification will be available in 5 years. Then facilities will have easy access to positive identification of patients at any time in any location.