Use Bar Coding to Streamline Medical Practice Processes

My favorite low-cost, low-effort, high-impact solution for a medical practice has been a sheet of labels for each patient, printed with the patient’s name and DOB, and attached to the patient’s paper chart.  The labels save time by eliminating the need to write the patient’s name on encounter sheets, prescriptions, and orders. They are always legible, and there are no transcription errors.

I am a little sad that EHR adoption is making this trick of my trade obsolete, but I recently realized medical offices can take advantage of a tool I discovered while working in another industry: bar coding.

What is a bar code, and how does it work?
A barcode is an optical machine-readable representation of data.  The original scheme, referred to as one-dimensional or 1D, represents a set of characters (capital letters, single digits, and some special characters) by the width of vertical lines and the spacing between them.  

The most common example of a 1D barcode is the UPC, or Universal Product Code.  Widespread adoption of the UPC by the grocery industry in the ‘70s made it unnecessary to individually tag each can of green beans with a price tag.  It also made it possible to change prices instantly and with essentially no labor.

UPC Code:

Bar code readers use a photo sensor to read the barcode and capture the represented data.  Some can store the data for later download to a computer, but most perform the same function as a keyboard.  That is, the human readable data is inserted at the location of the active cursor.

How can bar codes streamline processes in a medical office?
Bar coding preserves all of the advantages of the pre-printed labels I referred to above, and it provides two others:
1.There is no need to manually enter the data.  The bar code reader captures the data and delivers the data to the location of the PC's cursor, for instance, within an EHR. If an EHR does not accommodate the direct input, it is necessary to capture the data to a temporary document and then cut and paste it into the EHR.
2. The bar code reader captures the data or it produces an error condition.  Bar coding is more reliable than Optical Character Recognition because the symbols are tightly controlled.  There is no variability.  If the reader cannot recognize a configuration, i.e. character, there is an error and the reader knows it.

What are some ways practices could use bar coding?1. The practice could use bar coding to label paper documents received from patients and other facilities or providers before scanning them into the EHR. The ideal solution would be to print the bar coded patient name and a secondary identifier directly onto the documents, but attaching a label works, too.  Either way, bar coding will enable the document to be clearly and permanently identified in a way that works for the practice and minimizes data entry.
2. The practice could use bar coding to help manage medication, vaccine, and sample inventory. For this use, a sheet of bar coded labels for each lot is definitely the way to go if the barcode on the item is not compatible. The bar coded label should include the name of the medication, the expiration date, and the lot number. Scan the barcode when adding the item to inventory and when removing it.  It is much faster than typing in all of that information, and not subject to typographical errors.
3. Similarly, the practice could also use bar codes to keep track of other inventory, e.g., equipment and supplies.4. The practice could print a bar code identifying the patient at the bottom of each document you give to a patient to complete and return. This minimizes errors in the process of attaching returned documents to the patient’s electronic file, because the identifying information came from the patient's electronic file in the first place.

How would a practice create bar codes?
A practice can easily create bar codes from Microsoft Word and Excel and read bar codes if it purchases a bar code reader.
1. Bar codes are just fonts, like Comic Sans or Papyrus, and there are many of them.  The most common one is Code 3 of 9 (also known as Alpha39, Code 39, Code 3/9, Type 39, USS Code 39, or USD-3).   Barcode fonts may come with the barcode reader, or they can be downloaded for free from the internet and installed as fonts for the PC's Microsoft Office applications.
2. When creating a bar code, put an * on either side of what you want to be shown as a bar code.  (Some versions of Microsoft Word will interpret this as an instruction to BOLD the data.  If that happens, just hit UNDO.)
3. Make sure the bar code reader is expecting the bar code format it is being asked to decipher.
4. If the bar code printing application does not also provide the data in human readable form, the person formatting the label must.

Bar coding is remarkable. It is easy, inexpensive and reliable. I highly recommend it to increase both productivity and reliability in data entry.