Bar code tech and eMAR significantly reduce medication errors

By Mike Miliard
10:32 AM

A recent study out of Brigham and Women’s Hospital in Boston has shown that using bar code technology, in conjunction with electronic medication administration record (eMAR), substantially reduces transcription and medication administration errors as well as related potential drug-related adverse events.

The research, which appeared in the May 6 issue of the New England Journal of Medicine, was funded by the HHS’s Agency for Healthcare Research and Quality.

Bar code eMAR technology ensures that the correct medication is administered in the correct dose at the correct time to the correct patients. When nurses use this technology, medication orders appear electronically in a patient’s chart after pharmacist approval.

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The technology also alerts nurses electronically if a patient’s medication is overdue. Before administering medication, nurses are required to scan the bar codes on the patient’s wristband and then those on the medication itself. If the two don’t match the approved medication order, or if it's not time for the patient’s next dose, a warning is issued.

Researchers compared 6,723 medication administrations on patient units that did not have bar code eMAR and 7,318 medication administrations on patient units that did. The implementation of bar coding linked to an eMAR was associated with a 41 percent reduction in non-timing administration errors and a 51 percent reduction in potential drug-related adverse events from these errors.

Errors in the timing of medication administration fell by 27 percent. Transcription errors and their associated potential drug-related adverse events were essentially eliminated.

"Our study shows that this set of technology can make the delivery of hospital care safer," said lead study author Eric G. Poon, MD, of Brigham and Women’s Hospital, Boston. "However, hospitals need the right set of resources and human talent to deploy this technology successfully so more research is needed to identify ways to implement it in the most cost-effective way."

The findings have important implications since bar-code eMAR technology is being considered as a 2013 criterion for meaningful use of healthcare IT under the American Recovery and Reinvestment Act.

"Medication errors in hospitals are a very serious issue and can often lead to patient harm," said AHRQ Director Carolyn M. Clancy, MD. "The good news from this study is that using bar code technology and an electronic medication administration record together can be an important intervention to achieve medication safety."

The authors also suggest that decision support embedded within computerized physician-order entry (CPOE) and bar code eMAR technology would play complementary roles in medication safety efforts. While CPOE is more likely to prevent errors that result from bad judgment, insufficient knowledge, or incomplete clinical information when choosing a therapeutic plan, bar code eMAR technology is more likely to prevent errors associated with memory lapses or mental slips in executing a therapeutic plan.

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Digital Transformation

Top row - left to right: Dr Don Rucker, National Coordinator for Health Information Technology (ONC), HHS Office of the Secretary, US, Tim Kelsey, SVP - Analytics, HIMSS, Australia and Dr Ahmed Balkhair, Saudi Arabia’s Digital Transformation Advisor, Ministry of Health. 

Bottom row: Dr Anne Snowdon, Director of Clinical Research - Analytics, HIMSS, Canada.

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