BARCODE SYSTEMS

DEPT. OF HOSPITAL ADMINISTRATION

J. N. MEDICAL COLLEGE, BGM

INTRODUCTION
Bar codes have infiltrated every face of our lives; you
can find them in grocery stores, hospitals, department
stores, jails, on farms, even in your own home. They
have become an accepted part of our society, but what
exactly are they and what do they represent? They all
seem to look the same, but they are not. Different
industries have developed their own standards for bar
code content and format.
Ms.Sophy

WHAT IS A BARCODE?
A bar code is a graphic representation of data (alpha,
numeric, or both) that is machine-readable which shows
data about the object to which it attaches.
Bar codes are a way of encoding numbers and letters by
using a combination of bars and spaces of varying widths.
Both the lines and spaces are read.
They may be thought of as another way of writing, because
they replace key data entry as a method of gathering data.
Bar codes are a fast, easy, and accurate way of entering
data.

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WHAT CAN BARCODE DO?

Barcode connects Information and carries it:
Manufacturer ID, Article number, Expiration Date,
Lot/Charge number and additional data can be tied
together, uninterruptable, but prepared for automatic
scanning at any time.

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TYPES OF BARCODES
1. Numeric-only barcodes
2. 2 Dimensional barcodes
3. Alpha-numeric barcodes
4. Industry Standards for Barcodes and Labels

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BARCODE READER

A barcode reader (or barcode scanner) is an electronic

device for reading printed barcodes. Like a flatbed scanner, it
consists of a light source, a lens and a light sensor translating
optical impulses into electrical ones. Additionally, nearly all
barcode readers contain decoder circuitry analyzing the
barcode's image data provided by the sensor and sending the
barcode's content to the scanner's output port.
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TYPES OF BARCODE READERS

Pen-type readers
Laser scanners
CCD (charge-coupled device) readers
Camera-based readers
Video camera readers
Large field-of-view readers
Omni-directional barcode scanners
Cell phone cameras
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How do barcodes work?

There are lots of types of barcode, but the common one we all
see all the time is called UPC, the Universal Product Code.
Each digit is coded by two black and two white stripes. The
stripes have widths from 1 to 4 units, and the total width for
each digit is always seven units.
The barcode is made up of 12 digits, in various groups. The
first two show the country that issued the barcode. The next
four digits indicate the manufacturer. Some countries have a
three digit country code, so they only have three digits for the
manufacturer code.
The final six digits are a product code that the manufacturer
assigns. Every product has a separate code. Even different
sized boxes of the same product must have a different code.
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How do barcode scanners work?

Basically, there are 3 functional parts to the barcode scanner
itself, the illumination system, the sensor / converter, and
the decoder.
Bar-code scanners use Light Emitting Diodes (LEDs) to scan
the bar code, and reflect the image onto a Charge-Coupled
Device (CCD). The CCD transmits the information to a
computer that retrieves information about the product from a
database, and also adds information to the database that the
product was scanned.

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FUNCTIONS
Bar code technology can be translated into three
primary

functions:

tracking,

inventory

management, and validation. Whether you use one

function or a combination of functions, the benefits in
cost savings, improved productivity, and quality can
be substantial.

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TRACKING
Anything that can be identified with numbers (or numbers and
letters) can be tracked using bar code technology. Materials
management, central services, medical records, radiology,
pharmacy, and laboratory are areas where bar codes are
commonly found in hospitals.
Bar codes can be used to track a product throughout the supply
chain and clinical workflow.
They may be used to track a supply to a particular patient and
also can identify the clinician who used it with the patient.
For example, if a nurse discovers a defective supply item, bar
coding can help track the item back through materials
management and purchasing to the distributor and/or original
manufacturer so the hospital can obtain a refund.
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INVENTORY MANAGEMENT
Maintaining accurate inventory is a very complex process of
knowing what you have, how much of it you have, who has it,
where it is, how much it is worth, and when to reorder it.
Every hospital maintains centralized and decentralized
inventories that could include medical/surgical products, office
supplies, linens, pharmaceutical products, X-ray film, cleaning
supplies, laboratory products, and more.
Bar coding helps you manage these inventories wherever they
are located, so that the right materials are available when and
where you need them.
Using a bar code also can help you monitor usage patterns
throughout your hospital.
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VALIDATION
Validation assures that an action has taken place or that the
item you want is on hand.
The ability to validate an action by a bar code scan helps
reduce errors and waste, provides a management check on
productivity, and helps construct the necessary documentation
to meet requirements of the Joint Commission on
Accreditation of Healthcare Organizations (JCAHO) and
insurance companies.
The most important validating function is to verify that the
patient being treated is, in fact, the right patient and that the
treatment that is about to occur is appropriate.
Nurses can scan a bar code to confirm that the item they are
about to use with a patient is the item ordered by the doctor.
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 They also can validate that they have used the item with the
right patient.
Nurses do this by scanning the bar code on the employee
identification badge, the bar code on the patient wristband, and
the bar code on the item.
This type of validation typically requires that decision support
be in place to accomplish the checking function.

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Supply logistics and material management

coordination
The primary use of bar codes currently in the healthcare
supply chain is for shipping and receiving purposes.
Logistics packages use the data provided from the scanned
information to properly route, reorder, and receive supplies
from one inventory point to another, typically in a bulk
volume.
Bar codes placed on packing lists and delivery totes are
commonly used to track, identify and capture information
about orders and shipments both on the distributor/wholesaler
side, as well as within materials management information
systems at the healthcare site.

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 The information captured is then fed into respective systems to

complete and close out purchase orders, adjust inventory
levels, and initiate the accounts payable process.
Bar codes ensure the timely capture of accurate data within the
process and reduce the learning curve for the personnel
involved.
The increasing use of bar codes to capture data at the point of
use has evolved to create an increasingly efficient supply
chain by providing real-time visibility of the inventory levels
on the nursing units.

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BARCODE IN HOSPITALS
Hospital environments are the ideal location for the
implementation of barcode and RFID data collection systems and
software, from admission, to bedside care, to accurate medication
administration, to tighter control of inventory.
Inventory Management
Fixed Assets Management
Intake/ Registration
Bedside
Medication dispensing
Patient Discharge
Printing and Consumables
Access Control
Radiology, Lab and Pharmacy
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Inventory Management
Managing inventory in hospitals has long been an important
task, yet it is often overlooked in the busy environment. By
initiating a program that utilizes barcodes, hospitals can
control inventory supply areas with ease, as well as keep track
of all equipment in use across the enterprise.
Inventory functions can basically be broken down into two
separate categories: stockroom applications and check
in/check out applications. Stockroom inventory applications
track consumable items (e.g., medication and supplies), while
check in/out applications track shared or re-usable items (e.g.,
X-rays, lab results, diagnostic tools, and other medical
equipment).
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Fixed Assets Management

Tracking fixed assets is similar to taking inventory; however,
fixed assets are located all over the hospital and are generally
stationary. These items can include medical equipment,
computers, televisions, chairs, beds, etc.
By utilizing a handheld computer, similar in shape and size to
a PDA, a single worker can walk around scanning barcodes
that are on objects, and then run a report of all items in the
hospital showing which items are missing or have been
moved. Financial reports, indicating the depreciation of assets
over time, can also be generated.

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Intake/Registration
Bar-coding provides an application that allows a nurse
with a mobile cart, equipped with a wireless laptop and
mobile printer, to greet patients' as they walk through
the doors of the emergency room. The nurse records
patients' information and prints out a wrist band for
them to wear, as well as a medical chart that is marked
with a barcode. By putting a barcode on the chart in
the beginning, other doctors and nurses throughout the
hospital can scan that barcode and have instant access
to patients' records.
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 By bar coding the patient wristband that must be worn by the

patient, caregivers and hospital support staff can ensure that
patient identification is completed before administering
medications, processing diagnostic procedures or simply
transporting the patient to another part of the hospital.

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 By connecting to the hospital's network, the nurse is able to

verify the patients' insurance information, facilitating the
triage and admission process in the ER.
After patients' are examined, the physician scans the barcode
on their chart and enters notes and other pertinent information
which is then wirelessly transmitted to a central database
where patients' files are automatically updated.

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Bedside
At the patients' bedside, nurses and staff can use fixed and/or
portable batch/wireless data collection devices to scan both the
barcode on the patients', as well as on the patients' chart to
verify they are talking with the right patient, thus increasing
bedside security. Upon verification, nurses can view and
update patients' medical charts, check vital signs, insert notes,
and use cross-checking tools to expand patient care at the
bedside.

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Medication Dispensation
When it is time for patients' to receive medication, the nurse
once again scans both the patients' wrist and chart to ensure
they have the proper patients, and then scans the medication to
check that it is right for the patients.
Through mobile connection to the hospital's database, nurses
can decrease the possibility of a fatal mistake through
improperly administered drugs.
This application can be implemented utilizing mobile medcarts, equipped with PDAs/pentabs/laptops, scanners and
printers, as well as a med tray for multi-patient administration
at floor-level. At this stage, a running record is created for
future reference of each dispensation of medication.
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Patient Discharge
When patients' are ready to leave the hospital, scanning
technology can be used at bedside, the discharge office, or
via mobile cart to record the discharge and transmit billing
notification to the main system. Certain devices can also be
equipped to accept co-pays in the form of cash, check, or
credit card.
Additional applications that can be integrated include
alerting nurses of newly opened beds, scheduling patients'
follow-up visits, or setting/ modifying billing information.

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Printing and Consumables

Printing your own labels and ID bracelets has many benefits,
including allowing you to customize the look and feel of your label
as well as to produce labels on-demand. Barcoding can help you
with label printing applications (w/barcodes and/or RFID chips) in
the following areas:
Inventory labels
Fixed asset labels
Patient wristband bracelets
Patient charts
Lab documents
Lab results
Test tubes & vials
X-rays/MRI film
IV bags
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Access Control
Hospitals can use bar coding, mag-stripe, or RFID systems to
track employees through the use of an ID card/tag system.
Each different system has its own benefits and drawbacks that
need to be considered when deciding on an access control
system. These systems can track time and attendance, as well
as limit access to certain parts of the hospital for nurses,
doctors, and staff. Additionally, an access control system
allows you to monitor who enters and exits your facility.

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Radiology
Labeling - Notes/Charts/Film
The first step to more accurately tracking notes, charts, and
film is to print and affix a barcode label to each document
produced within a lab. For example, X-rays or MRI results can
be associated with patients' and tied in to their history.
Inventory
With a check in/check out solution, anything that is taken out
of the radiology lab will be scanned out of inventory and
tracked, allowing you to know what doctor/nurse is utilizing
each chart or X-ray produced in your department. You can also
track any equipment that may leave your facility for any
reason to ensure its return in a timely manner, reducing the
risk of replacing lost or missing equipment
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Laboratory
There is no place in a hospital where it is more critical to
accurately track each vial, test tube, and sample to ensure
each is associated with the correct patient. By creating
labels at the point of collection with a portable printer,
they can be applied to the sample for tracking purposes.
This will immediately associate the samples with the
correct patients or application, reducing the risk of mixing
up test results and thus reducing your facility's exposure.
Different types of labels can be used depending on the
specifications needed, such as for those stored in extreme
temperatures or exposed to certain chemicals.
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Pharmacy
Printing and Consumables
By using a barcode printer and barcode-generating software,
you can print labels individually or multiple labels at a time.
These labels can be affixed to medication and bin & shelf
locations; this lets you expedite check-out, and more
conveniently and accurately track your inventory. Bar coding
offers a myriad of batch and wireless hardware and software
solutions to automate your inventory process.

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RF/Batch Data collection

Either done using a wireless connection (RF) or through batch
collection, barcode-based data collection with mobile
computers is imperative to accurately monitor inventory in
today's pharmaceutical manufacturing and distribution
environment.
Batch data collection refers to types of applications in which
information is collected and stored on a handheld terminal.
After the work is complete, the handheld is placed into a
docking cradle, and the information is uploaded all at once
into the host application. Batch applications are ideal for scan
intensive work in which the collected data is not needed in
real-time.
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 Wireless data collection, or RF data collection,

though more expensive to implement than
batch, will provide you with updated
information in real-time. This can be important
when the information is time sensitive and the
information needs to be updated constantly.

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DOCUMENT MANAGEMENT
Bar codes can be used in several ways to enable efficient and
accurate management of paper documents and files.
Many hospitals use bar coding of patient medical record
folders and patient account files to keep accurate file locator
systems.
Scanning the bar code on charts as they are checked out and
returned is fast, easy and accurate.
With portable scanners, official and unofficial satellite storage
locations can be inventoried efficiently.

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 Bar coding can provide many benefits when documents are

printed for use and returned for processing.
For example, bar codes can be included on a patient statement
to identify the patient and the healthcare encounter.
Including a bar code on the part of the statement that the
patient remits with their payment helps to ensure accuracy.
The patients account number would be encoded on the
statement. Upon receipt of payment, the bar code would be
scanned and credit issued to the proper account. This helps
eliminate manual data entry and ensures that payments are
applied to the proper account.

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Process logistics

Bar coding can help any workflow that requires hospital staff
to write down who or what they are working on. These can
include:
Annual equipment inventories
Preventative maintenance
Patient charges
Linen inventory and distribution
Sterile reprocessing
Gas cylinder tracking
Movable equipment management
Forms inventory
Patient menu requests.
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The Advantages of Bar Coding

Data Collection
Savings
Analysis
Training
Flexibility
Accuracy of data input (error free)
Timely feedback
Improved productivity
Represent unique identity of a product
Labour savings by avoiding manual system
Real time data collection
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Disadvantages of barcodes
Pricing Issues
Damaged Labels
Upfront Cost
Training
Printer Requirements
Dot matrix and ink jet printers cannot print high-quality bar
codes.

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