Point of Use Bar Coding Solutions in the OR

The lack of standards in healthcare is simply unacceptable. That’s why companies like GHX and most all of the GPOs are so passionate about the issue. Standards are essential because they enable interoperability. A mouthful. But even that’s just the tip of the iceberg.

Let’s just consider something as simple as point of use bar code systems –the way they’ve been used in retail stores. They are based on a simple, yet powerful technology. And the standards used are universal and readily applicable to healthcare. Relatively speaking, they’ve been around forever. Imagine that all inventory locations in a hospital are monitored and items are scanned as they’re being used. They are scanned and an order is sent to the warehouse so that the inventory can be replenished – and at the same time an invoice would be generated and sent to the billing system. In retail, it’s standard practice, but in health care, most of the marketplace continues to manually track par levels or they’re using a basic technology that doesn’t link logically to other systems –like ERP, MMIS or charge masters.


Anesthesiologists are the only health care professionals in the hospital setting who dispense, premix, repackage, re-label and administer medications without independent verification. Given that most drugs administered perioperatively are high risk, the potential threat to patients is obvious. The OR and the post-anesthesia care unit disproportionately accounted for 81% of all medication error reports, which exceeds by fivefold the error rates reported in the rest of the hospital. In addition, more than 60% of medication errors committed by anesthesiologists are related to the removal of incorrect ampoules or vials from anesthesia drug trays, incorrect labeling of syringes after admixing and syringe swaps during surgery.

Errors are often system-driven, a result of the fast pace of the OR workflow combined with a lack of redundant checks and balances. As one anesthesiologist said, “we’re very good clinicians, but we’re not machines…throughout the hospital, there are safety steps in place to prevent medication errors, but not in the OR.”

In January 2010, a simple bar code system was implemented for use by anesthesiologists in several Canadian hospitals. The process required the anesthesiologist to scan every drug ampoule and syringe label for accuracy verification throughout drug dispensing, premixing, administration and documentation. Electronic anesthesia data capture produced a complete intraoperative record that funnels directly to the electronic medical record, which means that the anesthesiologists no longer have to document their actions after the procedure, as they had to previously.

Now, after 23 months and more than 300,000 doses administered in more than 20,000 surgical cases, no medication error incidents related to mistaken drug identity have been reported when bar-code scanning was used. A single critical drug error occurred when an anesthesiologist bypassed the bar-code scanning process.


There are few examples where technology that buys badly needed efficiencies in SCM doesn’t also dramatically improve care quality/patient outcomes.

—Tom Finn

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