According to the American Society of Health System Pharmacists recent newsletter, there is no law or regulation that requires prescription drug labels be decipherable by blind or visually impaired patients—and therefore no compelling reason for insurers and pharmaceutical firms to improve the use of medications for the blind and visually impaired.

However, the Veterans Health Administration (VHA) has finalized its plan to provide audible prescription reading devices to more than 33,000 blind veterans.

The VHA purchased the ScripTalk Audible Prescription System, which uses radio frequency identification (RFID) technology. The patient positions the battery powered hand held RFID reader to within a few inches of the specially printed label, which has an embedded microchip and antenna. A synthesized voice gives the patient's name, drug name, instructions for use, special warnings, expiration date, prescriber's name, pharmacy phone number, and prescription number.

A printer in the pharmacy produces readable information and encodes the RFID microchip in the label.

According to an article in the Cincinnati Business Courier today, the RFID tags tested at Cardinal Health's warehouses in New York and Boston failed to meet the 'reads-per-second' rate that the manufacturer promised. The accuracy of the reads was in the 96% to 98% range.

The technology is being used to help combat counterfeit drugs by improving the tracking of drugs. Columbus, Ohio-based Cardinal Health is one of the nation's largest prescription drug distributors. The company expects RFID systems to yield long-term benefits, but offered that technical problems in the early stages need to be fixed before the technology can be utilized in the drug industry.

The FDA wants the technology deployed in the drug supply chain by 2007.

Sacramento-based Sutter Health is one of the first hospital chains in the nation to put bar codes on patients and their pills. After using the bar codes for a full year at 10 of its hospitals, Sutter has found that the bar codes averted 28,000 medication mix-ups, out of 2.6 million doses. From the Sacramento Bee:

About 9 percent of the time, or in 2,600 cases, patients were saved from what could have been moderate or serious harm. The impetus for Sutter and a handful of other hospitals to try bar coding drugs was a groundbreaking study, released five years ago this week, that jolted the medical industry with a deadly statistic.

As many as 100,000 Americans a year were dying from preventable medication mistakes in hospitals, according to the report from the Institute of Medicine, prepared by a committee of the nation's top scientists, doctors, and health policy experts. "That was a call to action," said Gordon Hunt, chief medical officer for Sutter.

Armed with that study and others that soon followed, Hunt said he was able to persuade Sutter's board of directors to spend $25 million to put a bar code scanner at every bedside at all 26 of its hospitals in Northern California by the end of next year. At that price, Hunt does not expect a financial return on his investment. "The return is in healthier patients," he said.

Having confirmed the consistent accuracy of a Radianse indoor positioning solution in locating patients and staff, Radianse and Massachusetts General Hospital, Boston, have launched the second phase of a study funded by the National Institutes of Health.  From Radianse's press release:

The $1.5 million, 18-month grant will be used to validate the use of accurate, time-stamped location data to objectively measure care processes. MGH use its Radianse IPS to provide real-time location data about surgical patients as they move through the continuum of surgical care.

The NIH-funded project will also seek to demonstrate the cost effectiveness and utility of deploying this system in the surgical environment. Early results will be available in late 2005.

The RFID chip from Applied Digital Solutions that links patients to their medical records has kicked up a media furor over potential privacy concerns after the Food & Drug Administration approved it earlier this month. From eWeek:

But so far, analysts remain largely skeptical that the technology will have any substantial impact yet for patients. Rather than sparking a technological revolution, it seems the RFID (radio frequency identification) chip may be drawing attention to flaws in the existing health IT infrastructure.

"The reaction to it is out of proportion," said Mark Leavitt, medical director at the Healthcare Information and Management Systems Society. "There's more controversy than there needs to be. It's just a higher-tech version of the medical ID bracelet."

RFID is emerging as a fully automated solution for information delivery at the bedside. In the last decade, the health care industry has made strides in adopting technologies to improve patient safety and hospital workflow. One example is barcode technology, but barcode technology has not yet fulfilled its promise. From Advance for Health Information Executives:

While it offers distinct advantages over traditional identification methods, it is still susceptible to human error, because it relies on multiple manual steps performed by the caregiver. Moreover, because it requires the user to physically scan a label, the barcode approach allows for caregivers to bypass the scan and defer entering the information, which obviates the benefits of the technology. Finally, the process steps that a barcode model adds tend to complicate hospital procedures, often making it more difficult for health care professionals to concentrate on providing quality care.

As more eyes become fixed on the future of the health care industry, another technology has emerged that more readily suits existing hospital workflow and is less invasive to both caregivers and their patients. Radio frequency identification, or RFID, enables a fully automated solution for information delivery at the patient bedside, greatly reducing labor and the potential for manual error.

The Food and Drug Administration has approved an implantable computer chip that can pass a patient's medical details to doctors, speeding care. From the AP: 

 
VeriChips, radio frequency microchips the size of a grain of rice, have already been used to identify wayward pets and livestock. And nearly 200 people working in Mexico's attorney general's office have been implanted with chips to access secure areas containing sensitive documents.

Delray Beach, Fla.-based Applied Digital Solutions in July asked the FDA (news - web sites) for approval to use the implantable chip for medical uses in the United States. The agency had 60 days to reply to the "de novo" application. It's the first time the FDA has approved the use of the device, though in Mexico, more than 1,000 scannable chips have been implanted in patients. The chip's serial number pulls up the patients' blood type and other medical information.

Loiusville, Kentucky's Baptist Hospital East officials are preparing for the day in the not-so-distant future when there are not enough technicians to process all of the hospital's blood samples. Those workers' replacement — a robotic line — already is hard at work, said Gail Burke, lab administrator and director at Baptist Hospital East. From Business First of Louisville: 

"The reason we started this project was we had so many (medical technicians) that are close to retirement age," Burke said. And there is a shortage of training programs in the area, she said, so hospital officials turned to technology. The Baptist Hospital East lab technicians and robot process between 4,000 and 5,000 blood samples each day, Burke said.

When nurses enter lab orders into the hospital's computer system, the lab

Secretary of Health and Human Services Tommy Thompson praised mandatory moves toward bar codes on drugs at the annual meeting of the Biotechnology Industry Organization Monday, but said additional technology could ensure greater safety. From the eWeek article:

"While bar codes can make sure that the right drug gets to the right patient at the right dose, RFID technology is the next logical step. RFID advances have made the technology cheap enough to be employed against counterfeit drugs," Thompson said.

California Connected, a weekly hour-long newsmagazine produced by PBS stations in Los Angeles, Sacramento, San Diego and San Francisco, recently examined issues related to radio frequency ID tags and the FDA's consideration of the technology to increase prescription drug supply chain security and prevent counterfeit drugs from entering the system. Guests on the program included California state Senator Debra Bowen, author of the first proposed regulation of RFIDs; Beth Givens, director of the Privacy Rights Clearinghouse; Xeni Jardin, a technology journalist; and Mark Roberti, editor of RFID Journal. Video of the May 6th segment is archived online at the program's website. The site also includes a transcript of the show's weekly Web chat, which focused recently on the potential efficiency gains and privacy risks associated with RFIDs.

Valley Presbyterian Hospital, located in Van Nuys, California will begin piloting electronically coded wristbands for outpatient surgery patients this summer. According to the Los Angeles Daily News, the wristbands, which will store information on a microchip, could help reduce the risk of medical errors. The pilot program is expected to run several months, with the possibility of full implementation by 2005. The bands are produced by Precision Dynamics Corporation. From the LA Daily News:

The information on the wristband is accessed through a small antenna, using radio frequency identifications technology. The data can be transmitted through clothing, bed coverings and other nonmetallic materials.  "If the pilot is successful in outpatient surgery, then it will be extended into all surgery and then housewide," said Sallie Naber, Valley's director of general services.

Over 100 hospitals in New Jersey intend to implement bar code technology to prevent medication errors. A recent survey of the state's hospitals found that a few had implemented bar code technology and about half were "actively looking" to assess or install a system. From the Gloucester County Times:

[Bar code] technology is being integrated into the state's 113 hospitals, according to Aline Holmes, New Jersey Hospital Association director of quality institutes. With healthcare versions of bar-coding technology, patient wristbands encoded with prescribed treatments must pass through successful "wanding" before drugs can be administered.

"The computer system behind the whole thing says, this is the right patient at the right time at the right dosage," Holmes said, noting the new technology requires hospitals to evaluate nurse and pharmacist procedures. "If you don't look at the whole process … you have more confusion."

In its May 3 issue, Nursing Spectrum said bar-coding has been shown to reduce medication mistakes by as much as 87 percent because of extra checks put in place.

Auto-ID Labs, the MIT organization that helped develop radio-frequency identification, is investigating how RFID and related technologies can be used by the healthcare industry for tracking pharmaceuticals and other applications. The company recently announced the creation of the Healthcare Research Initiative, a research project that will study the use of RFID, mass serialization, and sensing technologies in health care.The research will be done in collaboration with EPCglobal Inc., the organization overseeing the development of RFID standards, and with health-care companies and industry associations. From InformationWeek:

Auto-ID's goal for the project is to provide an objective body of research that health-care companies can draw on when making RFID deployment decisions. The project, for example, will examine whether RFID emissions have any effect on pharmaceutical products. Auto-ID will also conduct physical trials of its research to validate its findings. 

Standard-setting organization The Joint Commission on Accreditation of Healthcare Organizations [JCAHO] has proposed new requirements for hospitals to develop a plan to implement bar code technology by 2007 under the organization's 2005 National Patient Safety Goals for hospital accreditation programs. With a manadate to improve the accuracy of patient identification, JCAHO's 2005 plan requires that healthcare organizations introduce bar coding that would ensure proper identification of patients and match them to their specific medications and treatments.

JCAHO is an independent, not-for-profit organization that was established over 50 years ago.  It is governed by a board that includes physicians, nurses, and consumers.  JCAHO sets the standards by which health care quality is measured in America and it's impramatur is sought by virtually every hospital and healthcare organization in the U.S. The proposal comes on the heels of the recent FDA ruling requiring bar coding on drugs and biologicals.

The final FDA medication barcode rule is expected to spur rapid growth in hospital bedside scanning. A report by research firm The Neuenschwander Company, headquartered in Bellevue, Washington has released a report this week that compares 20 vendors ready to assist hospitals with barcode technologies for drug safety checks. The report, "To the Bedside: A Review of Point of Administration Barcode Scanning Systems,"  comes on the heels of an FDA regulation mandating that medication labels include a linear bar code containing the National Drug Code (NDC) number, beginning April 26.  From Neuenschwander's Business Wire release:

"The FDA barcode rule is a tipping point which will result in widespread adoption of medication scanning systems," said Mark Neuenschwander, a long time proponent of bedside scanning and president of The Neuenschwander Company. "The value is obvious. Scanning is to patient safety what seatbelts are to passenger safety," he explains. "Both save lives."