WHITE: Because of the technically complex creation method, 3-D labels are virtually impossible to duplicate, greatly inhibiting the ability to produce counterfeit products. This helps materials managers ensure proper product pedigree.

BLACK: A 2-D or data matrix barcode enables more data to be compressed in a small footprint, allowing codes to be placed on smaller packages. While 2-D barcoding will allow some additional small packages to be barcoded, I am not certain that that we will see widespread usage in the near term. A linear barcode typically includes a human readable GTIN below the barcode. As hospitals transition to scanning, it would be advantageous to have human readable data right below the barcode. When hospitals begin transacting using GTINs, the human readable data available in a linear barcode becomes critical as a back up source of data.

LEE: Some people have used 3-D to describe a color barcode. There are multiple versions of color barcodes, but it is difficult to control colors among all printers and to calibrate those colors with readers. The financial woes of healthcare investment in technology are too great for hospitals to seriously consider further investment in 3-D applications. Healthcare has adopted 2-D symbologies and recognizes their value. [Five] years ago, a healthcare IT professional would not have recognized an Aztec code, but today its very common place for them to say ‘that’s an Aztec code.’ The value of 2-D barcoding over linear barcoding for specific use cases, e.g., wrist bands, labeling small vials in the pharmacy, etc., is now widely understood.

FUNKHOUSER: As in the case of 2-D codes being able to contain more data in the same physical space as a 1-D code, similarly might a 3-D code be able to contain more data than a 2-D code. It is not clear if 3-D is either necessary or easy to reliably implement due to the nature of how 3-D codes are presently designed – color is the 3^rd dimension – today’s 2-D codes are robust and data-rich for their given physical sizes.

MAKHANIK: Currently, 3-D barcodes on medical devices are by far the exception, accounting for an estimated less than half of 1 percent of all barcodes. They have the advantage of packing the same amount of information into a much smaller space, but reading them requires more sophisticated – and expensive – scanners. Their use only makes sense where labeling space is at a premium, such as on small vials, syringes, or some pharmaceutical products. Since the vast majority of medical products have packaging large enough to accommodate 2-D barcodes, there is not much incentive to move to 3-D barcodes at this time.

WHITE: Three things will keep barcode applications relevant; the cost of the label, the cost of label-producing equipment and the availability of readers.

Labels are currently produced and affixed to virtually all products within the hospital. The additional cost of adding barcoding symbology is virtually zero. No new technology has that promise.

Barcode labels can be produced using the printers currently utilized throughout hospitals today. Therefore, the implementation of a barcoding solution would incur no additional label-producing equipment costs.

Barcode label readers have proven to be extremely durable and reliable. They can be embedded in a wide range of equipment and hand-held devices that can be attached to most any data entry interface. Most hospitals already have a vast supply of barcode readers that can be deployed for a wide range of applications.

BLACK: While I don’t question the usefulness of RFID for tracking some products today, I don’t expect RFID or RTLS to replace barcodes any time soon – if ever. We’re comparing active to passive technologies. RFID is great for mass scanning, but it is challenged with selectivity. In some applications, the barcode is in fact the best way to identify a product or package being used for a specific transaction.

Cost may also play a factor. For some medical devices, the cost of the RFID tag would exceed the cost of the individual product. It does not seem likely that the market will bear the expense of putting RFID tags on these low-cost products. The industry also has to consider the data needs and infrastructure necessary to implement RFID on a large scale.

The key objective of barcoding is product identification. The relevancy of the barcoding system will be dependent on having an evolving database that can provide useful product information that can be accessed using barcode reference numbers. We need to collectively implement GDSN, synchronize our data and modify all or our systems before we even attempt widespread use of RFID.

LEE: Barcoding will remain the lower cost labeling and reading solution for most applications. RFID and RTLS are compelling solutions for some applications, but until the overall cost comes close to a barcode system, the threat of barcode obsolescence is not a great risk.

FUNKHOUSER: Because of their ease of use, global acceptance and inexpensive design, barcodes will remain prevalent in their current form for the foreseeable future. We do not anticipate RFID to replace barcodes. They are two separate technologies and have different applications that we believe will co-exist for a long time. Each technology can be deployed throughout the organization to track assets and people. It is important to assess the needs and goals in conjunction with budget to determine which workflow will provide the greatest benefit, ROI and lowest total-cost-of-ownership in the end to achieve the organization’s goals.

MAKHANIK: Concatenated barcodes and 3-D barcodes are two examples of technological developments, as is the emerging GS1 standard being pushed by hospitals to standardize barcodes for the healthcare industry. But the main selling point for barcodes over RFID and RTLS will continue to be economic, particularly when it comes to tracking perishable, consumable products. RTLS simply has not turned out to be as economically viable as predicted. Even Walmart and the Department of Defense have cut back on their expansion plans. The chips themselves are one factor. In the hospital environment, where only a handful of medical products come with embedded RFID tags, materials management or clinical staff have to code and affix them to each and every package themselves, creating a huge loss of productivity. RFID sensors are another problem area, since they can and do fail, and if not placed properly can leave ‘dead zones’ where products simply disappear from system view. The advantage with RFID and RTLS of knowing where items are is counter-weighted by the burden and expense of implementing and maintaining these systems. The ROI simply isn’t there. Barcode systems offer an ROI in the 400 percent-800 percent range and will be the dominant technology for years to come for this simple reason alone. Moreover, a more than sufficient level of granularity and integrity of the data is achieved with barcodes, without justifying the use of more advanced technology that is vastly more costly.

Where RFID and RTLS technologies make more sense is for tracking long-term/permanent assets, such as beds, wheelchairs, portable defibrillators, IV drips, even patients. These items and patients are continuously moved around within a hospital and locating them quickly and easily is essential. Although costly and time-consuming, it can be financially justifiable to invest in an RFID/RTLS infrastructure for tracking such permanent and valuable assets.

DE MARTINI: Barcoding and RFID will co-exist for a long time. There are some applications that are better suited for barcoding, such as [barcoded medication administration] and others that are better suited for RFID, such as RTLS.

RFID is more expensive and requires a more complex and costly implementation than barcoding, but there are some areas where RFID may be an advantage. In the pharmaceutical supply chain, RFID may actually replace barcodes and be beneficial in tracking where a medication has been from the time that it was manufactured all the way through its supply chain until the time it reaches the patient. By using an RFID chip to maintain an electronic pedigree, or e-pedigree, of the medication, information about the medication’s handling throughout the supply chain can be read and written. This enables easier product recalls and also helps to identify where it is and if it needs to be used first before it expires.

Other applications may be better suited for barcoding, however. Lower-cost goods, for example, may not be well-suited to track via RFID. Using a 10-cent RFID chip on a [bandage] that costs less than a cent, does not make sense from an economic perspective. Therefore, there will continue to be many places where it will make more sense to use a barcode than it would be to use an RFID chip.