Fascination during much of the last decade with radiofrequency identification (RFID) and real-time location system (RTLS) technologies aside, bar coding probably should be farther along than it is, particularly with the resurgent interest in supply chain data standards.

But it’s not. Why? And where should it be implemented that makes the most sense…and cents?

Healthcare Purchasing News Senior Editor Rick Dana Barlow posed those questions to a half-dozen experts regarded as thought leaders in the healthcare information technology field. Here’s what the group had to say.

Implementation requires the involvement of many departments with conflicting priorities, budgets and procedures. The institutions that have successfully implemented bar coding have benefited from a single champion — someone with the technical knowledge, organizational skills and political clout to manage across departmental boundaries.

Some hospitals are waiting for new technologies such as RFID. Institutions are learning that while these technologies hold a lot of promise, they have several shortcomings including, cost, accuracy, interference, special equipment and more. Bar coding is available today, and label printers and readers are abundantly available throughout any hospital.

Bar coding is not seen by clinicians as an efficiency improvement. A frequent objection is that bar coding "slows down the process." But, in terms of medication delivery, it is better to focus on accuracy and safety rather than speed and efficiency. Once installed, users find that the accuracy gained by bar coding becomes an efficiency improvement as well.

"I am not sure where to begin," "I am not sure what information is contained in a bar code," "The product I need to scan doesn’t have bar codes," and "I need to revise my systems first."

These are four reasons healthcare providers have cited as barriers to adopting scanning programs. Although barriers certainly exist to adopting scanning technology in hospitals, the value proposition is overwhelmingly positive (evidence from retail). Increased use of electronic health records, the FDA’s pending UDI regulation and a tightening financial environment all suggest that hospitals will accelerate their adoption of scanning products.

Funding is typically the number one reason given for a lack of adoption, although it is not directly tied to bar coding, but to a larger IT investment. Bar coding is a bonus or feature that can be utilized effectively in healthcare, but without the initial investment in an IT system, hospitals can not implement bar codes. Healthcare decision makers clearly see the value of bar codes and are moving forward with adoption; however, adoption has not been as quick as in other industries. Honeywell continues to help educate the healthcare industry on bar code implementation and selection of the best symbology for their applications.

Motorola’s Enterprise Mobility Healthcare Barometer, an annual study based on interviews with IT directors, CIOs and users show that the top barriers to adopting mobility in association with patient safety and bar coding are, in order of priority: Security concerns; cost of the hardware; cost of software, integration, service and support; difficulties integrating mobile applications with existing infrastructure; and interference/performance problems. This is reflective of the same concerns and challenges associated with a bar coded patient safety deployment for medication administration.

Motorola offers an array of mobile computing, bar code scanning, RFID and wireless network technologies to solve healthcare industry pain points. Working closely with our partners, we are able to provide solutions that meet the varying needs of a diverse customer base. Our ability to mobilize applications efficiently and effectively helps to improve patient care and lower total-cost-of-ownership.

The two reasons I hear most frequently for not adopting a barcode system are probably, first of all, pre-conceptions about the cost and hassle of implementing a new system and second, a general lack of awareness for how bar codes can help transform their way of doing business.

Many people assume that installing a new barcode system will be expensive and disruptive. They don’t realize that a new system can typically be installed over a weekend at very minimal cost. It’s not at all like installing an RFID system, which requires the hardwiring of scanners in multiple locations, or a cabinet-based system, which involves pulling out old cabinets and putting in new, custom-designed ones. With a more advanced and sophisticated barcode system, all you do is plug the off-the-shelf scanners into a few computers, do an initial scan of your inventory and you’re done. That’s it.

 A lot of people also don’t fully realize all of the benefits of a newer-generation barcode system. Not only can it help prevent stock-outs of critical items and the use of expired or recalled products, it can also improve the rate of charge capture and reduce inventory bloat. A good system can therefore not only improve the quality of patient care, but also dramatically reduce unnecessary costs. It’s one of the few areas that everyone can agree on, and for that reason alone I think you’re going to hear a lot more about it as the healthcare reform debate gets underway.

Actually, within healthcare there has been widespread adoption of several different kinds of barcode applications. Labs, material managers, pharmacies, and even admissions areas are all using barcode technology to streamline activity and increase patient safety. However, bedside bar code medication administration (BCMA), or scanning a patient’s wristband and then scanning the medication before administering it to the patient, has not been widely adopted across the majority of hospitals. In fact, the industry is currently at about a 30–35 percent adoption rate.

One reason for this is that there has been an insufficient amount of implementation of computerized physician order entry (CPOE). For years, there has been a debate in the industry about which should come first — CPOE or BCMA. The general trend has been to push for CPOE first, due to the fact that the majority of medication errors come from incorrect order entry. However, the industry has come to realize that even though the majority of medication errors happen there, most of those errors are caught before the patient actually receives the medication so the error is corrected before the administration occurs. Because of this, the effectiveness, lower cost of BCMA, and easier implementation than CPOE has caused a dramatic increase in the adoption rate of BCMA year-over-year for the past few years.

WHITE: Equipment. There are too many documented cases in which patients were put at risk due to improper utilization of equipment, which could have been avoided through the implementation of some manner of bar coding. Bar coding of products and people is justified through the theoretical reduction in product waste and capturing expenses. These are important considerations, but I always make patient care the priority.