-by Marianne Kolbasuk McGee
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 drug makers 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.