Major Doubts Cast On Researchers Who Say Patient Barcodes Cause “Plethora of Problems”

Okay, I am going to have some fun with some well-meaning magazine’s published articles (by well-meaning “researchers”) that find examples of “how barcodes in patient care scenarios” are “causing” disasters (catch this latest title: Doubts cast on patient barcodes as research finds plethora of problems“) . We’ve blogged on this “barcodes cause problems” misconception in the past here, here, and here to cite just a few. I feel the need to be a little more assertive after this latest report came out yesterday, however, speaking just for me, I found the “plethora” cited in the report to be, well, rather ridiculous when examined one plethorum at a time.

So, this most recent one is on problems with scanning GS1 barcodes at the NHS. Let’s walk through the list of reasons provided. Now remember: this is not a joke. These are the examples cited. Please make sure you are not drinking coffee while you read this or you will be wiping up your desk.

1) You have a ruined or unreadable barcode that can’t be scanned. Well, duh, if its allowed to be applied to anything and its so degraded its unreadable, it won’t get read. If it was ruined en route to the patient bedside, should it have been delivered? I mean, if the label is ruined. . . It’s in violation of GS1 label quality standards. So your label printing is out of ink or the paper was loaded cock-eyed – the label is the cause of that  problem?  Somebody manning a label printer somewhere should be spanked.  Oh, and the example of the patient eating the barcode wrist band — weren’t they supposed to have been restrained in the first place?

Score: barcode: 1, Researcher: 0

2) A single 20mg order is delivered as two 10mg containers and the system the barcode scanner is connected to refuses to allow the scan to be accepted. Okaaaaaay. Is it just me or does this reflect a total misunderstanding of how computer systems work? The barcode on a 10mg bottle is not going to match the order because it isn’t what was ordered. Period. That’s because they aren’t the same, never were, never will be.  That’s good news, folks. Perhaps if the system reconciling orders and administration at the bedside was a little better programmed (as in: oh, yeah, 10 + 10 = 20) it would accept the scan.

Score? Barcode: 2, Researcher: 0

3) Nonbarcoded medications dont have barcodes. Exhale slowly now. Yes, this was cited by the researchers. Err, let’s see if I can muster a response where I’m not laughing at the same time: Um, yes, there probably is a problem with your barcode scenario at the patient bedside if you are attempting to scan something that has no barcode on it. What I don’t understand is why this wasn’t an example of a barcode positive . . . and I . . . really . . . don’t know what else to add. (Although I had to edit out several jokes on this one, feel free to provide your own. It’s shooting fish in a barrel.) This one should be worth double-points but no reason to pile on.

Score: Barcode: 3, Researcher: 0

4) Malfunctioning or broken scanners don’t read barcodes. Okay, I realize the barcode has to get read but this is like blaming your car keys when your car breaks down. I’ve posted about those crappy linear scanners and I know that’s what hospitals are buying because they are cheap. They got all the value they paid for and that has nothing to do with the barcode.

Score: Barcode: 4, Researcher: 0

These were some of the top cited, so you can imagine where the quality of complaints goes from here.

I can go on but hopefully it’s coming across clearly: barcodes are an enabling technology and if you don’t enable them, they don’t enable themselves. I do wish “researchers” would at least ask this question first when they look at “the evidence” they are compiling to produce their research report: does this anecdotal example pass the idiot stick test?

I agree there are serious issues with the wokflow around using linear scanners at the patient bedside. They should not be using cheap scanners if they are going to require scanned barcodes, among other things (all of the other things, in my mind, relate to workflow issues). Calling this a “plethora of problems” caused by the barcode itself isn’t research, it’s anecdote dressed up as analysis.