Drug Tracking: FDA Could Make Bar Codes Practical

When Sutter Health uses a drug-tracking system based on bar-code scanning, it adds about 5 cents to each dose of medicine. That's $1.6 million a year, given the 32 million doses its hospitals administer.

Nevertheless, over the next three years Sutter is rolling out to each of its 33 hospital campuses a computerized drug system based on bar codes. It's using Bridge Medical Inc.'s system, which prints a bar code that can be placed on single-dose packages.

But if a Federal Drug Administration rule is finalized requiring drugmakers to put bar codes on medicine bound for hospitals, Sutter CIO John Hummel predicts that per-dose cost will fall to 1 cent. That, combined with the safety benefits, might be low enough to spark adoption at hospitals around the country.

Developing and deploying the system will cost Sutter about $18 million, about $500,000 per facility, and is part of a larger $50 million technology initiative through 2006 that includes an electronic intensive-care unit. The investment is a sign of how health-care companies are getting more comfortable investing in technology. "The board approved this $50 million for technology fairly quickly," Hummel says. "In the past, for many health-care companies, it could've taken three to six years."

The Department of Veterans Affairs medical system pioneered the use of bar-code drug tracking, starting a pilot back in 1994 and rolling it out nationwide in 1999 and 2000. The system works like this: Before a patient gets a drug, the medicine's bar code is scanned, as are the patient's ID bracelet and nurse's ID badge. The information is checked against the patient's electronic medical records to ensure that it's the correct medicine, dose, and time, and to double-check possible allergies or adverse drug interactions. The system also can be used to check blood types before transfusions and to track lab specimens.

The workload on understaffed nurses is only one reason for such a system. The number of drugs available has grown 500% in the past decade to more than 17,000 in North America, according to a 2002 research paper by Dr. Michael Cohen of the Institute for Safe Medication Practices.

Sutter's Hummel says the bar-code systems will be vital in protecting patients from mistakes, since about half of adverse reactions happen because someone is given the wrong drug.

Studies of VA hospitals found more than a 75% improvement in errors related to wrong medication, patient, or timing. As the cost of creating such a system drops, more hospitals will find those kind of results within their reach.

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Photographs by Angela Wyant