Barcode eMAR system cuts down on medication errors

Electronic health record systems' true value rests not in their ability to act as repositories for great amounts of patient data, but rather the opportunity they present to physicians who can use that data in innovative ways. By mobilizing patient information to interact with other processes related to administering care, EHR systems become interoperable devices that physicians can use to inform and improve treatments.

According to a study conducted by researchers at Boston-based Brigham and Women's Hospital and published in the New England Journal of Medicine, medications that were ordered and administered with a barcode electronic medication administration system drastically reduced the number of errors and adverse effects in patients. The findings may prove that the benefits of EHR systems are only limited by the applications physicians can think up for them.

Cross-referencing medications with EHR information
According to American Nurse Today, errors in medication administration account for about 7,000 deaths annually. This makes preventable adverse drug events the number one cause of fatalities in inpatient care facilities across the country. In terms of critical care patients who typically require more medication than the average patient, 20 percent of medication errors are life-threatening, and 42 percent require life-sustaining treatments.

With these issues in mind, researchers at Brigham and Women's Hospital examined the effect of a barcode-enabled medication administration that linked up with patients' personal EHR files to ensure that there would be no unexpected complications. The researchers observed 3,082 order transcriptions and 14,041 medication administrations that occurred before and after the implementation of a barcode eMAR system.

The researchers found that medications that were not ordered and administered through the barcode eMAR system resulted in 776 nontiming errors, which were defined as mistakes not related to the early or late administration of the drugs. The use of barcodes and EHR systems saw only 495 errors of the same kind – a 41.4 percent decrease in errors. Additionally, adverse events fell from 3.1 percent without barcode eMAR to 1.6 percent with a 50.8 percent reduction. Finally, the barcode eMAR system did not result in any transcription errors, as opposed to its counterpart, which saw an error rate of 6.1 percent.

Mark Neuenschwander, president of the Neuenschwander Company and cofounder of the unSUMMIT for Bedside Barcoding, told Heathcare IT News that over two-thirds of hospitals in the U.S. already have some form of barcode eMAR in place. This could be due to the Centers for Medicare and Medicaid Services including barcoding in its requirements for meaningful use stage 2. 

Because barcoding improves patient care to such a demonstrative degree, Neuenschwander urged that healthcare facilities that have not done so already should implement such a system.

Neuenschwander told the news source that it is critical that hospitals use "technologies with best practices, [get] the final third to adopt and [get] all to expand their medication coverage."

Implementing barcode eMAR takes collaboration
Because a successful barcoding system incorporates information from nursing and pharmacy departments, effective communication and collaboration is the only way to adopt a functioning policy throughout an entire hospital.

Tina Suess, R.N., manager for medication safety integration at Pennsylvania-based Lancaster General Hospital, explained to Healthcare IT News that even though collaboration is important, a clear direction from a project manager may be even more crucial in adopting a barcode eMAR system.

For example, moving data from both departments to a decentralized location may be a mistake.

"Although this is better than not looking at the data at all … it doesn't allow a big picture look," Suess told the news source. "Hospitals need to define 'who' will own the data and oversee the process for improvements."