2-D Barcodes Can Automatically Update e-Health Records

New 2-D barcode application allows smartphones to scan vaccine label information into e-health records

Those of you who have come to know me, understand that I am a serious Tech-Head. I’m part of that early adapter club that can’t wait to get my hands on the latest gadget. My computer and I have a seriously close relationship. When this article popped up on one of my Tech-boards, my first thought was wow, how cool is that hardware/software interface.  Then as I re-read the article I started wondering about the use of the technology. Having my, or my son’s or grand children’s complete medical records neatly filed and available through the Microsoft Health Vault, doesn’t thrill me. Its not Microsoft’s  previous cloud-storage issues that bother me, or even the Blue Screen of Damocles that makes me nervous.  It is the, “What could possibly go wrong with that?” factor that is worrisome. Questions arise…

  • Who has access to this information — for what reason?
  • How do they access and manage the information?
  • When do they get it, and why?
  • What type of information is kept — for how long?
  • Where do patients go to assure accurate recording of medical info?

As vaccine manufactures have had more than their fair share of quality control issues that have required FDA recalls, the ability to trace batches of vaccine using a bar code recording device could be a good thing.
A new 2-D barcode application developed through collaboration between Cook Children’s Health Care System, e-health record vendor Athenahealth, Microsoft, and and vaccine makers Sanofi Pasteur and Merck  enables the nation’s first use of the 2-D barcodes on vaccines, allowing information about the drug to be automatically added to patients’ personal EHRs using scanners or smartphones. The process promises to an help clinicians and parents of pediatric patients to more easily manage vaccination information.

The use of 2-D barcodes on vaccines is allowed under a recently published guidance from the U.S. Food and Drug Administration that exempts a requirement to use 1-D or linear barcodes on vaccines.

Unlike linear barcodes, 2-D barcodes can contain more information about the labeled product, said Ryan Champlin, VP of operations at Fort Worth, Texas-based Cook Children’s, an integrated health delivery network that includes a medical center, a 300-physician group, and 60 outpatient offices.
By utilizing the 2-D barcodes, additional information about a vaccination can be instantly scanned into the patient’s records as well as supply chain and inventory systems, said Champlin.

“The vaccine vials are tiny, there isn’t much real estate” to include a lot of information on the drug label or on a 1-D barcode, he said. So, a vaccine’s product ID number, expiration date, and lot number typically would need to be visually read by a nurse, jotted down on paper, and then entered into an electronic health record, he said. “That opens the door to errors,” he said.

However, the 2-D barcodes can contain that product information in the small symbols, and when the image is scanned by Cook physicians it automatically updates patients’ AthenaHealth’s Web-based digital records system.

While Cook clinicians use small handheld scanners, the barcodes can also be scanned using smartphones. That allows patients’ parents or guardians to use their own phones to scan the barcode during a patient visit, and input vaccination information automatically into their child’s Microsoft HealthVault personal e-health record, Champlin said.
“We envision HealthVault being a lifetime record for patients to add and bring their medical information wherever they get care,” he said.
“This whole project plays into the bigger effort to make healthcare safer and less expensive,” he said.

“Many vaccines today require boosters, and no one remembers that time they received their last vaccine, like a tetanus shot,” he said. That often leads to patients being under or over vaccinated, he said.

While the 2-D application works with the Athenahealth EHR system used by Cook Children’s physicians, Champlin said the advancement of work by Cook, Athenahealth, Microsoft, and the two vaccine makers would allow “any e-medical record vendor to add a 2-D barcode interface” for compatibility with its EHR products, as well.
The collaboration between Cook, Athenahealth, Microsoft, Merck and Sanofi Pasteur was essentially a demonstration project to “prove we can get experts to use these barcodes” for vaccination information management in clinical settings, he said.

Each vaccine maker first needs to have its drug labels approved by the FDA before being used for 2-D barcode scanning applications such as this, Champlin said.
Besides updating patient’s digital records, the scanned barcode information can also be automatically sent to a state’s vaccine registry and be used to reorder a replacement for the administered vaccination. Cook is currently working on adding the inventory system capabilities to its deployment, said Champlin.

The 2-D barcode application builds on an existing alliance between Athenahealth and Microsoft that allows data exchange between Athenahealth’s practice management and EHR systems and Microsoft’s HealthVault and Amalga software.

Marianne Kolbasuk McGee,
October 13, 2011
URL: http://www.informationweek.com/news/healthcare/EMR/231900665


Author: H. Sandra Chevalier-Batik

I started the Inconvenient Woman Blog in 2007, and am the product of a long line of inconvenient women. The matriarchal line is French-Canadian, Roman Catholic, with a very feisty Irish great-grandmother thrown in for sheer bloody mindedness. I am a research analyst and author who has made her living studying technical data, and developing articles, training materials, books and web content. Tracking through statistical data, and oblique cross-references to find the relevant connections that identifies a problem, or explains a path of action, is my passion. I love clearly delineating the magic questions of knowledge: Who, What, Why, When, Where and for How Much, Paid to Whom. My life lessons: listen carefully, question with boldness, and personally verify the answers. I look at America through the appreciative eyes of an immigrant, and an amateur historian; the popular and political culture is a ceaseless fascination. I have no impressive initials after my name. I’m merely an observer and a chronicler, an inconvenient woman who asks questions, and sometimes encourages others to look at things differently.