News

Reality check: Debunking bar coding’s popular myths and perceptions
Last of two parts

If patient and product tracking technologies were likened to automobiles, radio frequency identification (RFID) and its other buzz-generating siblings would have to be classified as trendy sports cars and SUVs while bar coding would be relegated to the more traditional mid-sized or compact economy sedan categories.

But just as there’s nothing inherently wrong in occupying your garage or parking space with something practical, reliable and less exciting it’s also financially and operationally effective and efficient to rely on workhorse information technology like bar coding to keep tabs on patients and products.

As a result, Healthcare Purchasing News Senior Editor Rick Dana Barlow tapped 12 different experts from 12 different vendors in the bar coding market to react to 12 common provider perceptions about bar coding that have emerged through the years.

HPN recruited the following executives to provide clarity about the technology and its applications where there might be opaqueness.

● Jim Bagley, vice president, sales & marketing, Code Corp., Draper, UT (www.codecorp.com)

● Don Flynn, vice president, business development, Hand Held Products, Skaneateles Falls, NY (www.handheld.com)

● Laurie Hernandez, vice president of strategic marketing, Hospira Inc., Lake Forest, IL (www.hospira.com)

● Ken Kleinberg, senior director, Healthcare Solutions Division, Symbol Technologies Inc., Holtsville, NY (www.symbol.com)

● Keith Lohkamp, product strategist, Supply Chain Management, Lawson Software, St. Paul, MN (www.lawson.com)

● Suneil Mandava, president and CEO, Mobile Aspects Inc., Pittsburgh, PA (www.mobileaspects.com)

● Ralph Moher, director of corporate marketing and communications, General Data Co. Inc., Cincinnati (www.general-data.com)

● James L. Moore, vice president, EHS (Electronic Healthcare Systems), Freedom, PA (www.ehsmed.com)

● Debbie Murphy, global practice leader, life sciences, Zebra Technologies Corp., Vernon Hills, IL (www.zebra.com)

● Ken Perez, senior director of marketing, Omnicell Inc., Mountain View, CA (www.omnicell.com)

● Jamie Stallings, product manager, Healthcare/Retail Systems, SATO America Inc., Charlotte, NC (www.satoamerica.com)

● Jamie Wyatt, vice president, Health Industries, Oracle Corp., Redwood Shores, CA (www.oracle.com)

Last month, we highlighted five of the twelve. Here we spotlight the remaining seven.

1.  Bar coding may generate benefits for retailers and distributors but not as much for my storeroom, supply rooms and/or warehouse.

MURPHY: Stakeholders at all points of the supply chain, from the patient bedside to the point of production, are renewing their focus on traceability in response to growing safety concerns. Bar code technology can be used for anti-counterfeiting efforts to help hospitals ensure that medications are legitimate and can be easily tracked in the case of a recall. Another key consideration is how bar coding can lead to more efficient ordering and help prevent theft and loss. By using bar code technology, hospitals can track inventory, reorder effectively, and ensure right inventory levels for every kind of supply — from bandages to high value pharmaceuticals.

STALLINGS: Retailers and distributors have the same goal as the hospital storeroom, i.e., to know what is on the shelf at any given time. Simple bar coding allows for the automated entry of inventoried material, but each item must be located manually. On the other hand, RFID allows for vicinity inventory, which is the counting of material on the shelf without the need for each item to be located as the RFID tag ‘announces’ its presents. Libraries have used this method to count books on the shelf for years with great success. If properly implemented though, either system can keep current inventory based upon the removal of the item. 

WYATT: Bar coding has many potential uses in a healthcare organization, including receiving, picking, put away, returns, equipment management, asset management, dynamic put away, as well as serial and lot number tracking – all the while reducing or eliminating many of the manual errors in processes, such as picking and data entry errors. These processes will enable fewer touches, improve accuracy and provide more real-time feedback to staff and management, enhancing current business practices.

FLYNN: The benefits of bar code technology for all types of ‘track and trace’ applications across a range of industries are proven each day in tens of millions of reliable transactions. At Hand Held Products, our experience in helping hospitals automate supply chain tracking within a healthcare environment – from incoming to the store rooms and pharmacies and into the primary care units suggests unique differences in healthcare track and trace applications can easily be handled by AIDC technology

MOORE: The need to manage time and money in the healthcare storeroom is just as important, if not more, than for retailers and distributors. The use of bar codes and scanners can significantly reduce the time spent on manual processes, and help optimize your management dollars.

LOHKAMP: Lawson customers have seen tremendous cost savings and efficiency gains by using bar codes in combination with wireless applications for par and cycle counting. Bar codes are used to label shelves, bins or locations and indicate what products are supposed to be stocked there. Materials techs can simply scan a bar code label and enter a count to quickly record stock levels of a specific item. This allows materials departments to reduce stock outs and provide better service to their internal customers.

MANDAVA: Because of the fast-paced environment in a hospital, we have found that the biggest benefit actually comes within the four walls of the hospital rather than the general supply chain. Mobile Aspects has brought tremendous benefits and financial returns on investment to hospital storerooms, supply rooms and procedure rooms in as rapidly as six months in many of our installations across the country. Also, the elimination of compliance steps is a big advantage of our RFID systems. We have worked closely with cardiology, radiology and operating rooms departments over the last five years and developed solutions that integrate with hospital workflows, brings a proven financial return on investment quickly, and dramatically reduce the time clinicians spend in inventory management.

PEREZ: The experience of our customers indicates otherwise. Many hospitals have used Omnicell’s med/surg supply management solutions which utilize bar code technology in a variety of supply storage areas to great benefit.

MOHER: Bar code technology has proven across many industries to save time, reduce errors, and increase efficiencies. Countless studies with proven ROI models have been published that detail the benefits of bar code technology. The benefits of bar code data collection are transparent across all market segments if properly implemented. 

HERNANDEZ: The key value of bar-code systems in healthcare is their power to help prevent medication errors and thus save lives. In addition to providing identity confirmation at the patient bedside, bar codes allow us to reduce errors in the distribution and dispensing of drugs in the hospital. Case in point: Dispensing accounts for 11 percent of medication errors and 10 percent of preventable and potential adverse drug events (ADEs). These same codes have corresponding reference on all levels of packaging, which supports use of the codes for inventory control as well. Additionally, we have used bar coding in many of our manufacturing facilities for years and have seen benefits in warehousing, inventory tracking, productivity and quality.

KLEINBERG: The simultaneous read capabilities of RFID and the ability to write updated information to a tag have many benefits whenever assets and supplies are being managed. Tags may also be combined with temperature and motion sensors to store important information about the asset they are attached to.

BAGLEY: Bar code marking benefits apply to all levels of the supply chain, from manufacturer through distributor through pharmacy stores and final administration.

2. Unlike RFID, bar coding requires too many behavioral, equipment, facility and process changes.

KLEINBERG: Both RFID and bar coding have their own set of equipment and usage requirements – although they have much in common. Both technologies rely on attaching a label or tag to an asset and both technologies require readers (either portable or fixed) and back-end databases to manage the information being read from the items.

PEREZ: They are really two different animals, and both of them require changes in multiple areas. Bar coding is more established, with fewer unknowns, while RFID has more unknowns in terms of standards, the effort required to implement and maintain the system, costs, and the long-term viability of the solution providers. 

MOHER: In reality, the opposite is true. RFID systems are very complex and technical in terms of system design, implementation, management of data, and encoding and reading of the RFID chips. A bar code-based system, when properly designed and implemented, requires less facility and process changes than RFID.

HERNANDEZ: Virtually all new technologies in healthcare, including bar codes and RFID, require equipment, facility, process and behavioral or cultural change. Keep in mind, however, that is the goal here, too. We are trying to implement improvements in healthcare, and we can’t do this without implementing changes to our facilities, our processes and our behavior. Today, bar code-enabled point-of-care (BPOC) systems help improve patient safety, enhance patient care, optimize clinical workflow and facilitate hospital quality improvement efforts.

FLYNN: Actually, at this early stage in its evolution, RFID requires far more behavioral, equipment, facility and process changes, not to mention major disruption and investment in back-end legacy IT systems than does bar code technology. As a mature industry with proven standards and a full third party eco-system of software solutions and training resources, bar code is less traumatic to implement than RFID.

MOORE: Bar coding is as simple as using a flashlight. Simply press a button and aim the scanner beam to hit the bar code. With either technology behavioral, equipment, facility and processes will change and have challenges. In either situation, when properly introduced and implemented, the challenges can be minimized.

WYATT: Both technologies (RFID and bar coding) require behavioral, equipment, facility and process changes. If these issues are going to stop an organization from making operational changes today to take advantage of the benefits of bar codes, why would they make changes in the future to adopt RFID technology? The key here is to make the operational, application and technology changes now to take advantage of what RFID can do in the future. Why wait for the business benefits that could be five-plus years away with RFID?

LOHKAMP: Any new technology requires some degree of change in how staff work and the equipment and processes they use – even RFID. However, some of the technology investments and process changes required to successfully implement RFID are similar to those required for bar codes. 

STALLINGS: I do not see a difference with either on this point as the only difference is the type of tracking device used. Both require behavioral, equipment, facility and process changes. However, the greatest difference is in the cost of implementation. An enterprise-wide RFID system may cost several hundreds of thousands of dollars (USD) compared to tens of thousands for an enterprise bar coding system.  

MURPHY: Whether an organization opts for bar coding or RFID, the most effective applications of both technologies require process change. Neither technology can be viewed as simply ‘plug and play,’ and that is not necessarily a disadvantage. If an organization is considering an auto-ID technology, it is safe to assume there are limitations with existing equipment and processes that need to be addressed. In either case, assessing workflow, implementing new processes that support improved workflow and training are key steps for success.

BAGLEY: Bar code and RFID are both tools for management of pharmaceutical data. Use the right tool for a given job.

MANDAVA: Implemented properly, RFID should dramatically reduce the number of steps and time to do many processes in a hospital while bringing all of the financial benefits. For example, our iRISupply systems track the medical devices for the hospital, and automatically bill the patient for the item used, place it on their chart and reorder the product by integrating with their various IT systems.  This eliminates the need for manually writing this information down and entering it into the systems, which can often be prone to error. Bar code systems often do require a lot manual input which needs behavioral, equipment and process changes.  Imagine trying to scan a bar code on an item when a patient is on the operating room table in trouble! In the end, Mobile Aspects has realized that any system in the fast-paced environment of a hospital that relies on people to manually enter data by scanning bar codes or typing in data is prone to a high amount of error. We work to integrate with the hospital workflow and eliminate compliance. Implemented properly, with the workflow of the clinicians in mind, RFID can bring both all of the financial and operational benefits while eliminating many manual processes.

3. Bar codes are easily damaged via moisture, shredding, smudging, etc., which makes them potentially unreadable, while RFID only has problems with liquid and metal products to complicate scanning.

KLEINBERG: Although paper label bar codes are easily damaged by environmental factors – such bar codes generally cost less than a penny, whereas RFID chips can cost 20 cents to much more depending on the type of tag. If organizations wanted to make the investment, they could purchase or print bar code labels made from resilient materials using new technologies such as direct thermal printing. Patient wristbands, for example, can be purchased or printed very inexpensively or can be fabricated using advanced plastic materials that routinely hold up to weeks or months of abuse. Some companies have created specimen and tissue bar code labeling technologies that can hold up for decades. Direct part marking bar code techniques that etch or accrete the symbol right into or on the metal of surgical instruments are increasingly being used today and hold up to many years of use. In addition, fuzzy logic techniques used in decode algorithms are able to discern the information encoded in bar codes even if a significant portion of the bar code is damaged, and some 2-D bar code symbologies are designed with redundancy to still be read if partially damaged. It should also be mentioned that on the RFID front, there is much discussion about “paper-based technologies for inexpensively producing RFID tags – such approaches will likely suffer from the same environmental damage as paper bar codes. And even today’s more common RFID chips are not indestructible.

HERNANDEZ: Damage to product identifiers is always a risk. To help combat some of these issues, bar codes do have symbologies that contain repetition in the code. There-fore, if an area of the symbol is either damaged or inaccessible, a repeat section may compensate and allow for successful reading of the code. In the case of RFID tags, the currently fragile connections and computer chips can make them more susceptible to damage than a printed bar code.  

FLYNN: While it is true, paper-based bar code labels can be damaged, by using error correction technology found in 2-D matrix bar codes, you can damage up to 85 percent of a bar code label and still get accurate reads. For example, direct part mark (DPM) codes can be laser or chemical etched directly on to on objects surface, making them permanent bar codes. On the other hand, RFID has many issues with RF ‘propagation’ through liquids and other materials. RFID also has issues with ‘shadowing,’ making it difficult to know which RFID tag a reader actually picks up.

MOHER: These obstacles in bar coding are easily overcome if attention is paid to the proper selection of label media. There are a host of synthetic materials available that provide superior resistance to moisture, smudging and other damage, making them more durable than RFID chips. For example, General Data’s Personal ID wristbands, which allow for both bar codes and patient photos, are designed for long-term hospitals stays and the wristbands durable material and printing technology have proven effective against repeated exposure to moisture, smudging, scratching, etc.  In addition, our StainerShield labels are designed to withstand soaking in xylene for more than one hour without degrading or losing scannability. An RFID chip could never survive this severely harsh process. RFID chips are also susceptible to impact and electrostatic damage, neither of which would affect a printed bar code.

STALLINGS: This point must be conceded, however, if humans are 95 percent water and most medical equipment is or contains metal, then I think the statement is a straw man that is setup to be easily knocked down. Each technology presents its own benefit/detriment issues. The most successful implementations in healthcare will most likely be a combination of the two.   

WYATT: There are ways to minimize these issues by using more durable and water resistant labels. That said, these are relatively minor issues upon considering the potential business improvements that could be achieved by making changes today to adopt the bar code technology.

MOORE: No system or technology is perfect. But that shouldn’t prevent their use when so many benefits can be achieved.

LOHKAMP: While RFID tags can withstand many physical hazards, they aren’t indestructible. RFID also poses several additional challenges, such as multiple reads, misreads and interference. On the other hand, have the added benefit of being easily readable by people. So, if a bar code can no longer be scanned, staff can still read the bar code and manually enter the data.

MURPHY: Bar codes produced using thermal printing provide maximum readability and ease of scanning. Specialty bar code labels designed to work with thermal printers are coated, making them resistant to water, alcohol and soaps. It is important to note that hospitals opting for less expensive labels will not realize the ease of scanning, patient safety and ROI benefits that coated specialty labels provide.

PEREZ: Thermal printing of bar codes on synthetic materials produces a tough, durable data source that is virtually impervious to moisture and is long-lasting.

BAGLEY: Bar code labels that withstand extremes in terms of environmental requirements are inexpensive and available from the many printing support systems suppliers.

MANDAVA: Bar codes can be damaged for many reasons, as stated. Further, if a bar code is bent or ‘rounded’ (such as on a patient bracelet) it can be very hard to read. RFID eliminates all of these issues. However, RFID can be a complicated technology prone to many issues if not implemented correctly and requires a high amount of technical expertise. As well as metal, errant radio frequencies from other systems, distance, and even the orientation of an item can affect reading. Designed and implemented properly, an RFID system can get around all of these issues. Mobile Aspects has worked over the past five years to completely shield our cabinet from outside radio frequencies, and vice versa, to emit radio frequencies so our system does not affect things like imaging systems. Further, with our patented and patent pending designs, we have eliminated orientation issues and even most metal issues. We have hospitals tracking expensive metal orthopedics and other hospitals with our systems in the actual catheterization and radiology suites right next to their imaging systems.

4. Bar codes can’t carry data like RFID tags can.

MOORE: True. However, depending upon the data required, bar codes employed in a well designed, and properly implemented MMIS can be an efficient, cost effective way to achieve the necessary results.

STALLINGS: This is true of linear bar codes only. Once 2-D bar codes are implemented the bar code wins hands down, bar none. 

KLEINBERG: It’s a common misconception that RFID chips, because of their integrated circuit-based memory, would hold more information than bar codes. In fact, most RFID chips for the supply chain hold only a few dozen characters to keep the costs low – e.g., enough to hold an EPC code. Although normal size 1-D bar codes generally only hold a dozen or so characters, two-dimensional bar codes can hold hundreds, and depending on their size, even thousands of characters of data. Considering that many RFID inlays/tags for the supply chain have large antennae (e.g., four inches), a comparable-sized 2-D bar code label would likely encompass more information than such an RFID tag. On the other hand, RFID tags have the potential for sophisticated encryption and for being updateable one or more times, depending on the tag.

LOHKAMP: RFID tags can certainly carry a greater amount of data, such as tracking changes in and item’s temperature during shipment. However, two- and three-dimensional bar codes can carry significant amounts of data – enough information for many common applications.

MURPHY: Much like an RFID tag, two-dimensional bar codes also carry data. These codes store data both vertically and horizontally, enabling them to carry a significant amount of data. For example, the Aztec Code 2-D symbology can contain anywhere from 13 to 3,832 numeric characters or 12 to 3,067 alphabetic characters.

BAGLEY: 2-D labels carry significantly more data than RFID tags. Tag data (about 10 characters) can be rewritten. That is the main advantage.

MOHER: Two-dimensional bar codes can encode up to 7,000 numeric characters and more than 4,000 alphanumeric characters in a single printed bar code. This has shown to be more than adequate in the vast majority of healthcare applications.   

MANDAVA: RFID can carry many times more data than a bar code, whether it is linear, two- or three-dimensional. This is a big advantage over the bar code. Working with various manufacturers, Mobile Aspects has seen they see the benefits of using RFID as it allows them to put the detailed and complicated amount of information on every device or drug. We are working with manufacturers currently so they can bring more information to hospitals while also benefiting their own operations. 

HERNANDEZ: Bar codes and RFID tags are both data carriers. A two-dimensional bar code, for example, can be used to carry data including NDC number, product description, quantity, size, manufacturing location, etc. We have been able to use bar codes to successfully carry necessary data with all of our drug products.

FLYNN: The statement is highly ambiguous. Bar codes can store as much or more data than RFID tags, dependent on code and tag types. 2-D matrix codes can store binary data (to store, for example graphical images or machine code). RFID is a read/write media and dynamic write capability is a unique feature of RFID technology. However, many RFID tags do not support read/write capability and thus offers no data advantage.

PEREZ: According to a leading bar code printing tech-nology vendor, two- and three-dimensional bar codes can contain hundreds of characters of data with many, many data fields. While it’s true that RFID tags can carry a lot of data, two- and three-dimensional bar codes are not usually faulted for being unable to carry sufficient data.  

WYATT: Healthcare organizations can design their processes to take advantage of the value of bar coding today – and enhance that value in the future with RFID capabilities.

5. Bar coding is too expensive for me to cost justify and generate a return on investment.

FLYNN: Absolutely false. The reason bar code technology has grown and has been so widely adopted is it can deliver compelling ROI to all industry segments. The quest for broad-based, real and sustainable ROI is still uncertain for RFID.

MOHER: Numerous studies have analyzed the ROI on a bar coding system.  When properly  designed and implemented, the average return on investment of a bar code-based system is around 18 months. ROI models for RFID-based systems are difficult to analyze and determine, as RFID is still an emerging technology and needs to overcome barriers in technology, implementation and cost.  

MOORE: While no technology is going to fit every situation, properly designed and implemented bar code-based processes can easily generate a return on investment of 12 months or less.

HERNANDEZ: As a supplier, Hospira hoped to facilitate the adoption of bar code systems by supplying all of our drug products with bar codes down to the unit of use at no extra cost to the healthcare system.

LOHKAMP: Bar codes used in conjunction with mobile par and cycle counting or receiving at the warehouse dock offer measurable ROI. For example, BryanLGH Medical Center, one of our Par and Cycle Counting customers, has reduced the time needed to count par locations by up to 50 percent — 20 versus 40 minutes — in par locations with more than 100 items. BryanLGH also has saved 260 personnel hours per year using bar code scanning and wireless data transmission, enabling BryanLGH to count more par locations without adding staff.

MANDAVA: There are several applications for which RFID makes the most financial sense and other applications for which bar codes make the most financial sense. But it is now getting to a point where RFID makes sense in many more cases than the bar code. RFID should be used to track ‘valuable’ items such as devices, drugs and expensive supplies in a hospital. For these items, it brings a strong financial return on investment while eliminating many inefficiencies. There are also many other applications for RFID in a hospital. However, for less valuable things, a bar code solution may make sense. In the end, a hospital should analyze how an RFID solution can bring a strong financial return on investment quickly and see instances of the vendors solution at other hospitals as part of their due diligence.

MURPHY: The FDA estimates it costs $1,799 per bed to implement a bar code point-of-care (BPOC) system for medication administration and another $1,000 for annual maintenance. However, each adverse drug event (ADE) costs hospitals an average of $2,257, so a single ADE prevention practically offsets the BPOC investment cost for the bed. When you consider the average jury award for medication error cases exceeds $600,000, BPOC systems appear very cost effective. Smaller facilities are discovering that bar code medication administration systems even fit within their budgets — 30 percent of hospitals that have implemented BPOC systems have fewer than 150 beds, according to HIMSS.

The use of bar code technology also gives nurses automatic and immediate access to critical patient information, which introduces new efficiencies to clinical workflow processes and results in significant time savings. Bar coding technology can also be used to automatically move information from department to department, resulting even greater efficiency gains. 

If an organization is looking to increase and leverage the value of investments in bar coding, one option is to scale systems to include more applications and users. The IT department can play a powerful role in increasing the value of a bar code investment by setting technology standards that facilitate scalability and expansion. Features to insist on include support for organizational networking standards, conformance with wireless security protocols and compatibility with legacy HIS systems.

STALLINGS: If this is true, which I doubt, RFID is in a much larger ballpark and even costlier. It is believed if the ROI is presented correctly, one can easily justify a bar code implementation.

KLEINBERG: As stated above, bar coding is a relatively inexpen-sive commodity technology used in just about every industry. In the case of medication administration in a hospital setting, even with the costs of wireless networks and application software, the return on investment is generally received within the first year. Once a bar-coded medication administration system is in place, the same infrastructure can be leveraged for other valuable applications such as for specimen collection, blood transfusion verification, asset management, etc.

PEREZ: For med/surg supply inventory management, bar code-based open systems have provided a cost-effective solution with a compelling return on investment. One Omnicell customer reported 90 percent utilization compliance and a 28 percent increase in charge capture using a bar code-based open system. Another Omnicell customer reported a reduction in lost charges for its cath lab from 15-20 percent to 1.5 percent resulting from the implementation of a bar code-based open system. For the medication-use process, bar code technology should be a key component of any healthcare facility’s medication-error prevention strategy, a cause with compelling patient safety and risk management returns on investment.

BAGLEY: eMAR [electronic medication administration and reporting] applications are self-financing.

WYATT: The key is changing business processes to take full advantage of the technology that exists today. Process changes in receiving, ship-ping, put away, picking, annual physical inventories and cycle counting accuracy can drive significant improvements, thus cost justifying the expenses to move forward. If a healthcare organization plans on limited adoption of bar coding, or for that matter RFID, that organization is missing the greater value and probably missing the point of this type of technology altogether.

6. Bar codes aren’t reusable, unlike RFID tags.

LOHKAMP: The cost of reusable RFID tags equals the cost of using numerous disposable bar codes; thus, from a cost perspective, bar codes are usually more cost effective. In many common uses, such as shelf labeling or surgical tray tracking, bar codes can be used long-term.

MOORE: Actually, there are ways bar codes can be reused. Bar-coded asset labels and bin/shelf labels are two examples. Both can provide significant, cost effective benefits to the healthcare supply chain.

FLYNN: True. But if the RFID tag is not read-write enabled, RFID cannot be reused unless the data storage happens to be the same

MOHER: The concept of writing and rewriting data to RFID chips must be closely analyzed on an application-by-application basis in order to analyze the true benefits, costs and potential problems created by this process. Data integrity and security become big issues when patient information is encoded on a chip, rather than safely stored and protected within the hospital’s information system.

STALLINGS: True, but the reality is a great many RFID tags will not be reused either. 

MURPHY: One advantage of RFID tags is that you can rewrite information to them, but this capability is not available with all types of tags. 

MANDAVA: For tracking disposable items such as medical devices, drugs and supplies, both the RFID tags and bar codes on are not reusable. For many patient applications of RFID, they are also not reusable, as you do not want an RFID tag traveling from patient to patient. There are cases where an RFID tag can be reused, such as tracking portable equipment. Therefore, it is incredibly important for a successful installation that the hospital makes sure there is a strong, proven financial return on investment before implementing RFID technology. 

KLEINBERG: Yes, bar codes are generally used only once and RFID tags – especially the more expensive ones, can be reused. However, it is possible to reuse bar codes – for example, the bar code itself would have to be packaged within a plastic sleeve or protector that allows the bar code to be moved to another item when its use on the first item is no longer required. On the other hand, not all RFID tags are built to be reusable. Some can only be written once at manufacturing time, or only written to once in the field.

BAGLEY: However, the actual cost of recycling RFID tags for many applications exceed their value.

PEREZ: For good reason, bar codes are not reusable. As applied to consumable supplies and unit-dose packaged medications, the bar code is affixed to the packaging of the item. The bar code — tied to the item — is discarded when the packaging is discarded and/or the item is used, and rightly so. The value of RFID’s reusability applies more to reprogramming higher-cost active RFID tags for use with applications such as mobile asset tracking.

HERNANDEZ: Neither bar codes nor RFID tags on unit-of-use healthcare products are reusable because they are integral to the product labeling as unique identifiers. 

WYATT: Healthcare organizations can design their processes to take advantage of the value of bar coding today – and enhance that value in the future with RFID capabilities.

7. Bar codes from suppliers are not compatible with my internal systems in that they don’t provide me with the right information that I need.

FLYNN: Bar code technology has been successfully integrated with all types of legacy systems. The AIDC industry offers broad, strongly supported tools like terminal emulation, keyboard wedge and software middleware packages to ease the implementation burden of integrating bar code with your current systems. Unlike RFID technology, there is a strong, proven eco-system of third party systems integrators to help build compelling bar code systems, tailored to your specific requirements.

WYATT: Bar codes and RFID tags provide the core information needed to move and handle products. As the technology is adopted, there might be an expansion of what is available, but that does not preclude organizations from taking advantage of what exists today to improve processes. With RFID and bar coding, healthcare organizations can more accurately track assets and monitor key indicators, gain greater visibility into their operations and make decisions based on real-time information. It is also important to note that RFID tags are now being combined with sensors and tracking technologies like GPS to give companies greater visibility into their supply chains for reduced risk and optimized business processes. The key to leveraging the immense potential value of these sensor-based technologies is to begin initial investment today and start reaping the benefits available now. 

MOHER: Many healthcare systems develop and publish labeling requirements for products shipped to them from suppliers. These requirements specify the bar code symbology, format and the data encoded in the bar codes. They will also develop ‘lookup tables’ within their IT systems that can cross-reference the vendor-supplied data to their own internal data. 

MOORE: Responding to this statement is difficult without knowing what the right information is. But, again, there are many ways bar codes can benefit the healthcare supply chain, and to discount bar codes for those areas because a single application may not work would be a shame.

LOHKAMP: This same problem exists with RFID. Implementing bar codes or RFID tags requires a partnership with suppliers to understand the data required and a partnership with your software vendor to implement the best solution.

STALLINGS: Completely under-standable, this should be taken care of once a standard bar code is chosen. However, many buying groups contain the necessary clout to bring manufacturers into compliance. It is all a matter of muscle and the determination (or courage) to flex it.

KLEINBERG: The FDA bar code regulation only mandates that the drug NDC number be provided on the lowest level of medication packaging. Most applications can be readily adapted to utilize this information. Additional information that manufacturers provide on their packages may or may not be of value to a hospital – hospitals are encouraged to work with their GPOs, distributors, repackers, relablers and manufacturers to drive for the kind of information they would find most useful and in a format they could readily read.

MURPHY: Bar code printers and readers support multiple connectivity protocols and interface standards, which simplifies the task of integrating new bar code devices with hospital information systems. For example, many bar code printers are available with USB, Ethernet, 802.11-b-standard wireless and other network interfaces. Some models and options allow direct connection to XML applications and leading database and enterprise software systems. Because open, standard products are available, hospitals can set policies that require bar codes to comply with organizational IT standards. These devices also provide ease of integration with HIT software systems, another key consideration for the successful implementation of a bar code strategy.

BAGLEY: Commercially available data base systems that use the standard UPC coding to look up PDR data provides an off-the-shelf starting point for automatic data collection.

PEREZ: This is not a complaint heard from Omnicell customers using our bar code-based solutions. The information provided by suppliers is sufficient for inventory management, utilization tracking, etc. Bar codes from suppliers provide, at a minimum, standard information, e.g., NDC codes on medications, per the recently enacted FDA bar code rule. If a facility wishes to have added information embedded in the bar code, it could create its own bar code labels with the additional data.

MANDAVA: Bar codes only provide part of the information a hospital usually needs. In many cases, the bar code only provides the manufacturer and catalog number. It doesn’t include the expiration date, lot number and/or serial number and if it does, it is on another bar code requiring a second scan every time by a clinician. All of this information is vitally important in tracking devices and drugs within a hospital. Bar codes can only send part of the needed information to the IT systems in a hospital and require a lot of manual input in many cases. RFID systems allow all of that information to be entered automatically without any manual input such as bar code scanning or keyboard entry.

HERNANDEZ: Hospira products are bar coded with linear bar codes that should be compatible with all bar-code systems. Typically, hospitals will need to load product data and associate it with a bar code on first use. We have been and are happy to continue to partner with hospitals to assist with this process.