Bar
code battle: Which to use?
by
Julie E. Williamson ![]()
When the Institute of Medicine reported that 7,000 Americans die annually
from medication errors, all eyes turned to point- of-care, unit-of-measure
bar coding as a remedy.
Not only would bar codes ensure that drug identity and dosages are as
prescribed, and that medication is being administered to the right patient,
the institute said they would also safeguard against improper dispensing
and administration processes.
While few doubt their role in reducing medication errors, the question
still remains: Which bar code standard is best suited to the cause?
The industry currently has two standards to choose from: the Health
Industry Bar Code (HIBC) and the European Article Number/Uniform Code
Council data structure (EAN/UCC), the retail Universal Product Code.
The first uses numerals and alphabetical characters: the other uses
just numerals.
UPN initiative
The
Food and Drug Administration considers both standards acceptable. But
challenges with medical/surgical product distribution have prompted
a call for a universal product identifier.
Although the National Drug Council implemented a universally accepted
number to identify a specific drug, the med/surg industry didn't follow
suit until recently. Now a similar scheme, the Universal Product Number
(UPN), is the identifier of choice. It is endorsed by all member organizations
represented on the Health Industry Business Communication Council Board
of Directors, as well as the Department of Defense.
Bar code groups and health industry professionals agree the development
and widespread acceptance of the UPN is critical. By combining a manufacturer
identifier with an item identifier and level of packaging indicator,
the UPN offers a common language for the med/surg industry. It also
simplifies the supply-chain process from ordering to receiving.
Cuts
research needs
On the most basic level, the UPN enables customers to communicate their
needs to group purchasing organizations and trading partners without
cross-referencing. That means they can identify and order items without
extensive catalog research and can eliminate the need for large product
databases.
Manufacturers and distributors also can benefit from the UPN because
it increases visibility of manufacturer products and ensures that customers
placing an order can easily identify those items. At the same time,
distributors can cut costs by not having to develop and maintain multiple
cross-references to track product lines.
"Everyone
benefits from the UPN. [It] will facilitate electronic data interchange
transactions and will be an integral component of error reduction. Those
errors often occur when trying to cross-reference product identifiers,"
Health Industry Business Communications Council President Robert Hankin
explained.
Because the UPN incorporates both the Health Industry Bar Code and the
European Article Number/Uniform Code Council structure, it eliminates
the need for one primary data structure.
And because the two bar code structures use different manufacturer identifiers,
they are mutually exclusive:- the business communication council's Labeler
Identification Codes are alphanumeric and always begin with an alpha
character, while EAN/UCC codes are entirely numeric.
"This
makes it virtually impossible to confuse one bar code with the other,"
Hankin said. "And because all modern bar code scanners can read both
identifiers, there's no need to require the use of just one standard."
Are
alphas better?
While the UPN may keep the industry from having to choose between bar
codes - and save manufacturers millions in remarketing, printing and
repackaging costs - that doesn't mean the two standards groups aren't
vying for a bigger piece of the pie.
To date, the med/surg industry is virtually split down the middle in
its choice of bar codes, although the pharmaceutical industry predominantly
uses the EAN/UCC standard.
The Health Industry Business Communications Council, however, would
like to tip those scales, believing that its alphanumeric identifiers
and variable length format offers a higher level of security than its
fixed length, all-numeric counterpart.
The EAN/UCC, on the other hand, believes the code itself is what's important,
not the type of characters it contains.
"Whether
it's alphanumerical or all numerical, it's all just data," noted John
Roberts, director of healthcare for the Uniform Code Council. "We support
bar coding, period. Whether or not a [company] wants to use the alphanumerical
or numerical format is purely a business decision."
For companies such as Johnson & Johnson Medical that use alphanumeric
characters in their catalog numbers and prefer one standardized item
reference, the Health Industry Bar Code is a natural fit.
On the flip side, switching the healthcare business to the EAN/UCC standard
made sense for 3M because the company's 49 other businesses were already
using the EAC/UCC symbology. 3M's international counterparts also contributed
to the switch. Its European-based businesses said the HIBC standard
was not widely accepted, and that the UCC/EAN structure best met their
needs.
Despite their differences, both groups are moving forward with their
own set of error- reduction initiatives.
The Health Industry Business Communications Council developed automatic
identification standards that allow providers to employ bar code technology
and create a hospitalwide system that connects numerous departments
and functions relating to patient care. Auto ID replaces handwriting
and manual data input, and prevents confusion between drugs similar
in name or appearance. It also allows hospitals to instantly record
and trace every medication administration.
Pharmacy futures
According to Hankin, an increasing number of hospital pharmacies are
using the HIBC standard to generate bar codes for unit-of-measure medications
that aren't pre-labeled by the manufacturer.
Meanwhile, the EAN/UCC is working on 2-D reduced space symbology that
can fit on an item as small as a capsule and include a lot number and
expiration date. Roberts said his council is currently testing the scanning
accuracy of 10,000 RSS labels placed on 2mm vials.
"Many
medication errors could be prevented if manufacturers [bar coded] each
and every capsule, tablet or syringe," said John P. Santell, director
of the American Society of Health System Pharmacist Center on Pharmacy
Practice Management. "It isn't about the specific standard, it's about
the initiatives set forth by each [standard group]."
HPN
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