In my experience with implementing Electronic Medical Records (EMR) systems, I have been greatly impressed by the highly effective and promising bar coding technologies as specifically applied to EMR medication administration.

Patient medication error rates have been significant. Research has shown that there is at least one medication error per hospital patient per day. Studies indicate that 400,000 preventable drug-related injuries occur each year in hospitals, which result in additional costs estimated at 3.5 billion dollars. A 2006 study by the Institute of Medicine (IOM), reported in Preventing Medication Errors (National Academies Press) that at least 1.5 million preventable Adverse Drug Events (ADEs) occur each year.

Bar coding supports the principle of the so called “Five Rights” of medication administration –

• the right medication,
• the right dose,
• at the right time,
• with the right patient
• and the right route.

Today, bar coding improves safety of medication administration by leveraging the National Data Code barcode that is found on all medications today with the patient’s identification band bar code. As  EMR systems are implemented, a transformation of nursing care and medication administration business practices occurs leading to improved patient safety.

We are all aware of the safety benefist of patient bar coding. What I have found most interesting was a phenomenon reported in Preventing Medication Errors within nursing departments when they discovered how the medication administration “Five Rights” compliance could be tracked. Each ward and individual staff member’s compliance with the new medication administration policies was tracked by their new system’s audit trail reports. The phenomenon was an immediate error awareness when they could see audit trails illustrating medication administration compliance percentages by units and staff. Suddenly, compliance improved dramatically and a wave of positive competitive behavior emerged.

The end result of such enthusiasm by the healthcare teams has been translated into better patient safety by insuring the correct patient’s identity, and right medications or appropriate treatments being administered while reducing ADEs. Such enthusiasm can be contagious as we proceed with implementing new EMR systems and transforming patient care practices. We ARE moving forward!