Bar-Coded for Medication Safety
Posted by Matthew Novak on Mon, May 10, 2010 @ 07:50 AM
An article in the May 6, 2010, issue of the New England Journal of Medicine entitled "Effect of Bar-Code Technology on the Safety of Medication Administration" (full text available at http://content.nejm.org/cgi/content/full/362/18/1698) demonstrated a 41% decrease in medication administration errors, and a 51% reduction in potential adverse drug events from these errors. Such systems allow automatic documentation and cross-checks with a patient's other medical information at critical points: when the order is written by a doctor, the drug is prepared by a pharmacist, and when it is given by a nurse. Improved documentation may also help reconcile a patient's medication during transitions in care, such as during discharge.
Medication errors in hospitals are common, seriously impact patient safety, and are preventable. Bar code technology, used at grocery store check-out counters for decades, has the potential to dramatically reduce medication errors. However, new systems may also introduce new types of errors. In fact, the authors of the New England Journal article note that previous research on electronic medication administration systems (such as those using bar-code technology) have shown mixed results in terms of effectiveness in reducing error rates.
Many of the difficulties seen with information technologies such as this one occur during and soon after implementation. The electronic medication administration system evaluated in this study, at Boston's Brigham and Women's Hospital, had been implemented before the study was conducted. Given the seriousness of medical errors, hospitals have been reluctant to introduce clinical information systems that may present new types of errors, despite their potential for improving patient safety in the long run.
What do you think? Should hospitals be more aggressive in their adoption of such technologies? Are healthcare providers so careful not to commit errors, that they allow errors of omission (by forestalling potentially lifesaving advances in clinical information management)? Or, are they right to be so cautious? After all, errors in medication administration are far more serious than those in pricing groceries.