Medication errors are one of the most common medical mistakes and cause serious adverse events and even fatalities, adding to overall health spending. The chain from prescription writing to the patient taking the medication is complex and a number of steps have to been taken to automate various parts of the process to make it less mistake-prone. The New England Journal of Medicine reports on use of bar coding technology in one hospital. (NEJM Article)
The setting was a large academic medical center. Researchers examined rates of errors before and after introduction of a bar coding system. The bar coding system was used in conjunction with electronic prescription ordering. At the time of administration, the patient’s wristband bar code was scanned, as was the bar code on the medication. This allows verification of the match between the medication orders reflected in the patient’s record and the medicine actually being given to him or her. The system reduced error rates and adverse events by as much as 50% and virtually eliminated transcription errors.
Bar coding and other automation of the medication process have demonstrated the ability to significantly cut errors. Attention needs to be paid to possible unintended consequences, such as over-reliance on the system, inadequate training, or manual overriding of its capabilities. But when properly introduced into the overall workflow, the combination of electronic prescribing and bar-coded checks during administration of medication can make a substantial difference in quality of care and outcomes. Relatively small steps such as these can add up and improve the overall quality of our health system.