TEXT/PODCAST: Bar-Coded eMAR Reduces Errors

Using bar-code technology with an electronic medication administration record (eMAR) “substantially reduces transcription and medication administration errors, as well as potential drug-related adverse events,” says a new study funded by AHRQ. The findings have important implications because bar-code eMAR technology is being considered as a 2013 criterion for Meaningful Use under HITECH. (Skip to Podcast)

Researchers at Brigham and Women’s Hospital in Boston compared 6,723 medication administrations on hospital units before bar-code eMAR was introduced with 7,318 medication administrations after bar-code eMAR was introduced. Having bar-code eMAR technologies in place was associated with reductions in errors related to the timing of medications, such as giving a medicine at the wrong time, and non-timing medication administration, such as giving a patient the wrong dose.

The researchers documented a 41 percent reduction in non-timing administration errors and a 51 percent reduction in potential drug-related adverse events associated with this type of error. Errors in the timing of medication administration, meaning a patient was given medication an hour or more off schedule, fell by 27 percent. No transcription errors or potential drug-related adverse events related to this type of error occurred.

Bar-code eMAR is a combination of technologies that ensures that the correct medication is administered in the correct dose at the correct time to the correct patient. When nurses use this combination of technologies, medication orders appear electronically in a patient’s chart after pharmacist approval. Alerts are sent to 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 on the medication. If the two don’t match the approved medication order, or it is not time for the patient’s next dose, a warning is issued.

The study is published in the May 6 issue of the New England Journal of Medicine.

Eric Poon, M.D., Associate Physician, Brigham and Women's Hospital

A Podcast Interview with Lead Study Author Eric G. Poon, M.D., M.P.H., Corporate Manager II, BWH Clinical Systems, Partners Healthcare

Chapter 1: Topics Covered — Genesis of the study; is bar-coded eMAR a homerun?; importance of engaging clinicians in process redesign; cost of training clinicians; does the workforce exist to implement eMAR on a national level? [audio: One-on-One-W-Eric-Poon-Chapter-1.mp3]

Chapter 2: Topics Covered — bedside bar-coded eMAR vs CPOE; which to do first?; CPOE two halves — pure automation/CDS; Is CDS ready for primetime? [audio: One-on-One-W-Eric-Poon-Chapter-2.mp3]

Chapter 3: Topics Covered — What does it take to do CDS right?; Why does ONC want CPOE first?; Implementing advanced clinical technologies in a “cost-effective” way”; Is ONC looking at this report?: Must hospitals use one vendor for all?; Advice for CIOs moving forward with eMAR [audio: One-on-One-W-Eric-Poon-Chapter-3.mp3]