BARCODE SYSTEMS

DEPT. OF HOSPITAL ADMINISTRATION

J. N. MEDICAL COLLEGE, BGM

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INTRODUCTION

• Bar codes have infiltrated every face of our lives; you

can find them in grocery stores, hospitals, department

stores, jails, on farms, even in your own home. They

have become an accepted part of our society, but what

exactly are they and what do they represent? They all

seem to look the same, but they are not. Different

industries have developed their own standards for bar

code content and format.

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WHAT IS A BARCODE?

A bar code is a graphic representation of data (alpha,

numeric, or both) that is machine-readable which shows

data about the object to which it attaches.

Bar codes are a way of encoding numbers and letters by

using a combination of bars and spaces of varying widths.

Both the lines and spaces are read.

They may be thought of as another way of writing, because

they replace key data entry as a method of gathering data.

Bar codes are a fast, easy, and accurate way of entering

data.

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WHAT CAN BARCODE DO?

• Barcode connects Information and carries it: Manufacturer ID, Article number, Expiration Date, Lot/Charge number and additional data can be tied together, uninterruptable, but prepared for automatic scanning at any time.

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TYPES OF BARCODES

1. Numeric-only barcodes

2. 2 Dimensional barcodes

3. Alpha-numeric barcodes

4. Industry Standards for Barcodes and Labels

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BARCODE READER

• A barcode reader (or barcode scanner) is an electronic

device for reading printed barcodes. Like a flatbed scanner, it

consists of a light source, a lens and a light sensor translating

optical impulses into electrical ones. Additionally, nearly all

barcode readers contain decoder circuitry analyzing the

barcode's image data provided by the sensor and sending the

barcode's content to the scanner's output port.

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TYPES OF BARCODE READERS

• Pen-type readers

• Laser scanners

• CCD (charge-coupled device) readers

• Camera-based readers

– Video camera readers

– Large field-of-view readers

• Omni-directional barcode scanners

• Cell phone cameras

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How do barcodes work?• There are lots of types of barcode, but the common one we all

see all the time is called UPC, the Universal Product Code. • Each digit is coded by two black and two white stripes. The

stripes have widths from 1 to 4 units, and the total width for each digit is always seven units.

• The barcode is made up of 12 digits, in various groups. The first two show the country that issued the barcode. The next four digits indicate the manufacturer. Some countries have a three digit country code, so they only have three digits for the manufacturer code.

• The final six digits are a product code that the manufacturer assigns. Every product has a separate code. Even different sized boxes of the same product must have a different code.

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How do barcode scanners work?

• Basically, there are 3 functional parts to the barcode scanner itself, the illumination system, the sensor / converter, and the decoder.

• Bar-code scanners use Light Emitting Diodes (LEDs) to scan the bar code, and reflect the image onto a Charge-Coupled Device (CCD). The CCD transmits the information to a computer that retrieves information about the product from a database, and also adds information to the database that the product was scanned.

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FUNCTIONS

Bar code technology can be translated into three

primary functions: tracking, inventory

management, and validation. Whether you use one

function or a combination of functions, the benefits in

cost savings, improved productivity, and quality can

be substantial.

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TRACKING

• Anything that can be identified with numbers (or numbers and letters) can be tracked using bar code technology. Materials management, central services, medical records, radiology, pharmacy, and laboratory are areas where bar codes are commonly found in hospitals.

• Bar codes can be used to track a product throughout the supply chain and clinical workflow.

• They may be used to track a supply to a particular patient and also can identify the clinician who used it with the patient.

• For example, if a nurse discovers a defective supply item, bar coding can help track the item back through materials management and purchasing to the distributor and/or original manufacturer so the hospital can obtain a refund.

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INVENTORY MANAGEMENT

• Maintaining accurate inventory is a very complex process of knowing what you have, how much of it you have, who has it, where it is, how much it is worth, and when to reorder it.

• Every hospital maintains centralized and decentralized inventories that could include medical/surgical products, office supplies, linens, pharmaceutical products, X-ray film, cleaning supplies, laboratory products, and more.

• Bar coding helps you manage these inventories wherever they are located, so that the right materials are available when and where you need them.

• Using a bar code also can help you monitor usage patterns throughout your hospital.

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VALIDATION

• Validation assures that an action has taken place or that the item you want is on hand.

• The ability to validate an action by a bar code scan helps reduce errors and waste, provides a management check on productivity, and helps construct the necessary documentation to meet requirements of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and insurance companies.

• The most important validating function is to verify that the patient being treated is, in fact, the right patient and that the treatment that is about to occur is appropriate.

• Nurses can scan a bar code to confirm that the item they are about to use with a patient is the item ordered by the doctor.

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• They also can validate that they have used the item with the

right patient.

• Nurses do this by scanning the bar code on the employee

identification badge, the bar code on the patient wristband, and

the bar code on the item.

• This type of validation typically requires that decision support

be in place to accomplish the checking function.

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Supply logistics and material management coordination

• The primary use of bar codes currently in the healthcare supply chain is for shipping and receiving purposes.

• Logistics packages use the data provided from the scanned information to properly route, reorder, and receive supplies from one inventory point to another, typically in a bulk volume.

• Bar codes placed on packing lists and delivery totes are commonly used to track, identify and capture information about orders and shipments both on the distributor/wholesaler side, as well as within materials management information systems at the healthcare site.

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• The information captured is then fed into respective systems to complete and close out purchase orders, adjust inventory levels, and initiate the accounts payable process.

• Bar codes ensure the timely capture of accurate data within the process and reduce the learning curve for the personnel involved.

• The increasing use of bar codes to capture data at the point of use has evolved to create an increasingly efficient supply chain by providing real-time visibility of the inventory levels on the nursing units.

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BARCODE IN HOSPITALS

• Hospital environments are the ideal location for the implementation of barcode and RFID data collection systems and software, from admission, to bedside care, to accurate medication administration, to tighter control of inventory.

• Inventory Management• Fixed Assets Management• Intake/ Registration• Bedside• Medication dispensing• Patient Discharge • Printing and Consumables• Access Control• Radiology, Lab and Pharmacy

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Inventory Management

• Managing inventory in hospitals has long been an important task, yet it is often overlooked in the busy environment. By initiating a program that utilizes barcodes, hospitals can control inventory supply areas with ease, as well as keep track of all equipment in use across the enterprise.

• Inventory functions can basically be broken down into two separate categories: stockroom applications and check in/check out applications. Stockroom inventory applications track consumable items (e.g., medication and supplies), while check in/out applications track shared or re-usable items (e.g., X-rays, lab results, diagnostic tools, and other medical equipment).

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Fixed Assets Management

• Tracking fixed assets is similar to taking inventory; however, fixed assets are located all over the hospital and are generally stationary. These items can include medical equipment, computers, televisions, chairs, beds, etc.

• By utilizing a handheld computer, similar in shape and size to a PDA, a single worker can walk around scanning barcodes that are on objects, and then run a report of all items in the hospital showing which items are missing or have been moved. Financial reports, indicating the depreciation of assets over time, can also be generated.

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Intake/Registration

• Bar-coding provides an application that allows a nurse with a mobile cart, equipped with a wireless laptop and mobile printer, to greet patients' as they walk through the doors of the emergency room. The nurse records patients' information and prints out a wrist band for them to wear, as well as a medical chart that is marked with a barcode. By putting a barcode on the chart in the beginning, other doctors and nurses throughout the hospital can scan that barcode and have instant access to patients' records.

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• By bar coding the patient wristband that must be worn by the patient, caregivers and hospital support staff can ensure that patient identification is completed before administering medications, processing diagnostic procedures or simply transporting the patient to another part of the hospital.

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• By connecting to the hospital's network, the nurse is able to verify the patients' insurance information, facilitating the triage and admission process in the ER.

• After patients' are examined, the physician scans the barcode on their chart and enters notes and other pertinent information which is then wirelessly transmitted to a central database where patients' files are automatically updated.

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Bedside

• At the patients' bedside, nurses and staff can use fixed and/or

portable batch/wireless data collection devices to scan both the

barcode on the patients', as well as on the patients' chart to

verify they are talking with the right patient, thus increasing

bedside security. Upon verification, nurses can view and

update patients' medical charts, check vital signs, insert notes,

and use cross-checking tools to expand patient care at the

bedside.

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Medication Dispensation• When it is time for patients' to receive medication, the nurse

once again scans both the patients' wrist and chart to ensure they have the proper patients, and then scans the medication to check that it is right for the patients.

• Through mobile connection to the hospital's database, nurses can decrease the possibility of a fatal mistake through improperly administered drugs.

• This application can be implemented utilizing mobile med-carts, equipped with PDAs/pentabs/laptops, scanners and printers, as well as a med tray for multi-patient administration at floor-level. At this stage, a running record is created for future reference of each dispensation of medication.

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Patient Discharge

• When patients' are ready to leave the hospital, scanning technology can be used at bedside, the discharge office, or via mobile cart to record the discharge and transmit billing notification to the main system. Certain devices can also be equipped to accept co-pays in the form of cash, check, or credit card.

• Additional applications that can be integrated include alerting nurses of newly opened beds, scheduling patients' follow-up visits, or setting/ modifying billing information.

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Printing and Consumables• Printing your own labels and ID bracelets has many benefits,

including allowing you to customize the look and feel of your label as well as to produce labels on-demand. Barcoding can help you with label printing applications (w/barcodes and/or RFID chips) in the following areas:

• Inventory labels• Fixed asset labels• Patient wristband bracelets• Patient charts • Lab documents• Lab results• Test tubes & vials• X-rays/MRI film• IV bags

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Access Control

• Hospitals can use bar coding, mag-stripe, or RFID systems to

track employees through the use of an ID card/tag system.

Each different system has its own benefits and drawbacks that

need to be considered when deciding on an access control

system. These systems can track time and attendance, as well

as limit access to certain parts of the hospital for nurses,

doctors, and staff. Additionally, an access control system

allows you to monitor who enters and exits your facility.

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Radiology

• Labeling - Notes/Charts/Film

The first step to more accurately tracking notes, charts, and film is to print and affix a barcode label to each document produced within a lab. For example, X-rays or MRI results can be associated with patients' and tied in to their history.

• Inventory

With a check in/check out solution, anything that is taken out of the radiology lab will be scanned out of inventory and tracked, allowing you to know what doctor/nurse is utilizing each chart or X-ray produced in your department. You can also track any equipment that may leave your facility for any reason to ensure its return in a timely manner, reducing the risk of replacing lost or missing equipment

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Laboratory

• There is no place in a hospital where it is more critical to accurately track each vial, test tube, and sample to ensure each is associated with the correct patient. By creating labels at the point of collection with a portable printer, they can be applied to the sample for tracking purposes. This will immediately associate the samples with the correct patients or application, reducing the risk of mixing up test results and thus reducing your facility's exposure.

• Different types of labels can be used depending on the specifications needed, such as for those stored in extreme temperatures or exposed to certain chemicals.

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Pharmacy • Printing and Consumables

By using a barcode printer and barcode-generating software, you can print labels individually or multiple labels at a time. These labels can be affixed to medication and bin & shelf locations; this lets you expedite check-out, and more conveniently and accurately track your inventory. Bar coding offers a myriad of batch and wireless hardware and software solutions to automate your inventory process.

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RF/Batch Data collection

• Either done using a wireless connection (RF) or through batch collection, barcode-based data collection with mobile computers is imperative to accurately monitor inventory in today's pharmaceutical manufacturing and distribution environment.

• Batch data collection refers to types of applications in which information is collected and stored on a handheld terminal. After the work is complete, the handheld is placed into a docking cradle, and the information is uploaded all at once into the host application. Batch applications are ideal for scan intensive work in which the collected data is not needed in real-time.

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• Wireless data collection, or RF data collection, though more expensive to implement than batch, will provide you with updated information in real-time. This can be important when the information is time sensitive and the information needs to be updated constantly.

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DOCUMENT MANAGEMENT

• Bar codes can be used in several ways to enable efficient and accurate management of paper documents and files.

• Many hospitals use bar coding of patient medical record folders and patient account files to keep accurate file locator systems.

• Scanning the bar code on charts as they are checked out and returned is fast, easy and accurate.

• With portable scanners, official and unofficial satellite storage locations can be inventoried efficiently.

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• Bar coding can provide many benefits when documents are printed for use and returned for processing.

• For example, bar codes can be included on a patient statement to identify the patient and the healthcare encounter.

• Including a bar code on the part of the statement that the patient remits with their payment helps to ensure accuracy.

• The patient’s account number would be encoded on the statement. Upon receipt of payment, the bar code would be scanned and credit issued to the proper account. This helps eliminate manual data entry and ensures that payments are applied to the proper account.

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Process logistics

Bar coding can help any workflow that requires hospital staff to write down who or what they are working on. These can include:

• Annual equipment inventories• Preventative maintenance• Patient charges• Linen inventory and distribution• Sterile reprocessing• Gas cylinder tracking• Movable equipment management• Forms inventory• Patient menu requests.

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The Advantages of Bar Coding

• Data Collection• Savings• Analysis• Training • Flexibility• Accuracy of data input (error free)• Timely feedback• Improved productivity• Represent unique identity of a product• Labour savings by avoiding manual system• Real time data collection

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Disadvantages of barcodes

• Pricing Issues

• Damaged Labels

• Upfront Cost

• Training

• Printer Requirements

– Dot matrix and ink jet printers cannot print high-quality bar

codes.