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    Bar-code technology can enhance patient safety


    Bar-code technology is widespread in the general retail environment and is typically used to maintain product pricing information and to track inventory movement.

    Ned Milenkovich
    While its advantages have not yet been fully exploited in the hospital and community-pharmacy settings, bar-code systems of medication administration are being used to improve overall medication safety through verification that the right drug is being administered to the right patient at the right time.

    Several studies have shown that bar-code technology can significantly reduce errors in medication dispensing and administration. As technology continues to advance, it will be incumbent on pharmacy stakeholders to implement patient safety measures and for pharmacy boards to provide a regulatory framework that allows for this useful innovation.

    Bar-code technology has been shown to be useful in the hospital pharmacy setting. Most pharmacists would agree that using bar-code technology in their hospital pharmacies has made their workflow easier and more efficient. Studies conducted in healthcare facilities run by the U.S. Department of Veterans Affairs have shown that technology, specifically the use of bar-coding, is making patients' hospital stays safer, particularly in the area of medication dispensing and administration.

    From the hospital to the community setting

    Similar initiatives to translate hospital use of bar-code technology into the community-pharmacy setting have been successful. Use of bar-code technology frees the pharmacist from product-verification functions and allows for increased patient engagement in higher-level clinical services.

    In the case of mail-order pharmacies that often serve a nationwide patient base, use of sophisticated technology such as bar-coding enables these operations to process high volumes of prescription drugs for an extensive list of recipients.

    Properly trained pharmacy technicians can effectively use bar-code technology in dispensing medication. Use of bar-code technology provides assurances that each prescription is properly validated and fulfilled while a retrievable audit trail is maintained. Pharmacists, in turn, are able to make better use of their time through increased patient contact in such activities as immunization, medication therapy management, and counseling, as well as in complying with new FDA-mandated REMS for specified higher-risk drugs.

    The Institute for Safe Medication Practices (ISMP) has been actively engaged in the evaluation of bar-code technology. For example, "Assessing Barcode Verification System Readiness in Community Pharmacies" is being developed by ISMP to help address the reasons that bar-code scanning has not been implemented and to facilitate adoption of this technology in an estimated 27,000 community pharmacies that do not currently use bar-code technology for drug-product verification. The assessment is scheduled to become available at no charge on the ISMP website in late 2010. In addition, the National Association of Boards of Pharmacy, whose mission includes developing, implementing, and enforcing standards for the protection of public health, has recommended that bar-code elements appear on a prescription label to enhance patient safety.

    In general, state laws and regulations concerning pharmacy are not keeping pace in the area of bar-coding and other technology designed to automate and advance the profession.

    This may leave many vendors of pharmacy technology as well as permit holders confused about whether their technology is permitted and what metrics they must undertake to meet state law requirements. Nevertheless, this technology will continue to advance and the law will be forced to accommodate these innovations in order to further patient safety.

    NED MILENKOVICH is a member at McDonald Hopkins, LLC, and chairs its Drug & Pharmacy Group. He is also a member of the Illinois state board of pharmacy. Ned can be reached at 312-642-1480 or at

    Ned Milenkovich, PharmD, JD
    This article is not intended as legal advice and should not be used as such. When legal questions arise, pharmacists should consult with ...

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