Monday, December 1, 2014

This Is You on a Barcode

I had my annual physical exam last week.  Everything went fine until the doctor handed me a refill prescription for a helpful drug that I have taken for several years.

"Is this a barcode?" I asked, pointing at the side of the prescription sheet.

"They're required now," he said.  He was pretty steamed because New Jersey's recent adoption of barcodes on scrips required him to shred several pounds of old prescription pads.

"What's it for? I asked.

"To keep track," he said.

"Who's keeping track of what?" I asked.

The doctor shrugged.


Later I went online to look.  Turns out New Jersey is stepping up its examination of prescriptions of controlled substances, i.e., drugs like Vicodin and Oxycodone.  

I presume this means that people in one of our fine and efficient state agencies will examine every physician's prescriptions to count out how many controlled substances he or she prescribes on a regular basis.  I don't ingest controlled substances myself, but this probably wouldn't apply to me anyway because my barcode wasn't on the prescription sheet.  

It appears that a great big batch of data is being generated to search for needles in haystacks.  

In fact, every state specifies prescription sheets in its own way. California requires prescription pads printed by a state-approved printer.  In Indiana, the rules are set by the Indiana State Pharmacy Board.  There are tamper-resistant and forgery-proof papers and printing techniques.  There are bar codes.  Each state does things a little differently.

One company, Micro Format, Inc., seems to have carved out a nice niche for itself in printing and delivering state-accepted prescription pads to doctors.  So at least all the rule-making and rule-changing are generating a little economic boost.


In fact, Bar Code Medical Administration (BCMA) has been the hot new idea in medicine since sometime in the 1990s.  The thought is that specimen samples processed by medical labs would be coded with information about patients' medical histories, insurance coverage, next of kin and doctors' names.  So would wristlets for hospital patients. 

One famous study was cited in the New England Journal of Medicine in 2010 that purported to show how bar codes would reduce errors in hospitals.

The authors examined 3,082 order transmissions (presumably medications administered) in hospital settings.  Here were the results:

      -- There were 776 errors committed without the bar codes.

      --  There were only 495 errors committed with the bar codes.

The researchers concluded that the error rate was reduced by 41 percent with bar codes.  If the numbers are added up, it looks like 1,271 errors in 3,082 events.  This is not comforting.

My guess is that the barcodes were subject to at least two kinds of human errors: faulty data entry and failure to make use of correctly entered information.  Said another way, bar codes did not protect hospital patients from basic human incompetence.

Still, the march is on.  There are plans to sync up hospital patients' histories, medical indications and sundry personal data for easy access by any hospital employee with a scanner gun.  When that tech entrepreneur said several years ago that we have no privacy and we have to get over it, he had no idea how right he was.

Later:  RFID

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