Health Commission Drops Requirement for Bar Codes on Drugs

The Joint Commission on Accreditation of Healthcare Organizations drops its proposal to require the use of bar codes on drugs to prevent medication errors.

The nonprofit group that evaluates and accredits nearly 16,000 health care organizations and programs in the United States has dropped its proposal to require the use of bar codes on drugs to prevent medication errors.

The Joint Commission on Accreditation of Healthcare Organizations announced its national patient safety goals and associated requirements on Tuesday, after they were approved by the Joint Commissions board of commissioners earlier this month.

A spokesperson at the organization said the bar-code proposal did not make it to the Commissions board based on feedback during a field review by the Sentinel Event Advisory Group, a group of nurses, physicians, pharmacists and other experts who recommend specific goals to JCAHO. The proposal would have required that hospitals match patients to treatments using bar code technology by 2007.

In a survey of EHR trends released this week by the Medical Records Institute, 4.1 percent of respondents said they used a mobile health care application, such as bar coding at the bed side, to manage medications.

The American Hospital Association had objected to the bar-code requirement, saying that health care providers should be free to develop other procedures to prevent a patient from receiving medications and treatments meant for someone else. Nancy Foster, senior associate director of policy at AHA, said the association has supported bar coding as one way to prevent errors in care, but suggested that it would be more helpful not to specify bar coding.

"Were glad to see that they backed off from the bar coding in favor of general safety goals," she said.

However, she said she believes there will be a large increase in hospitals using bar codes over the next few years. "Many hospitals are very interested in adopting that technology, but they want to stage it to coordinate it with other information technologies being adopted."

Bar coding is also discussed in a survey released this month by Health and Hospital Networks.

Information technology could be used to achieve several of the national patient safety goals for 2005, although JCAHO did not require its use.

Most prominent in the list are requirements to find ways to acquire a complete list of a patients current medication and to make sure that that list is given to any subsequent health care providers to whom the patient is referred or transferred. Foster says it is unclear how many hospitals would have the electronic record capacity to accomplish this because both the hospital and the receiving organization would need to be able to receive the information. Less than 10 percent of hospitals currently have electronic health records.

This is information that many feel could be made available through EHR (electronic health records). However, the Medical Records Institutes survey indicates that this may not be the case. While health care providers overwhelmingly—88 percent—stated that a benefit of EHR was to share patient data, less than 40 percent of those participating in the survey said they could share patient data with a remote location. However, this could be an overestimate; the 436 respondents to the survey received e-mail requests to fill out the survey at the MRI or Toward an Electronic Patient Record Web site, and so do not represent the medical community as a whole.

According to the survey, top barriers to implementing EHR included "lack of adequate funding or resources" (56 percent in 2004 compared with 59 percent in 2002); "inability to find an EHR solution or components at an affordable cost" (36 percent in 2004 compared with 32 percent in 2002); "lack of support by medical staff" (35 percent in both 2004 and 2002); and "difficulty in finding an EHR solution that is not fragmented among vendors or IT platforms" (29 percent in 2002 compared with 34 percent in 2004).


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