Customized strategy drives this bar-code vendor

Despite all the hype on bar-code technology, less than 5% of the nation's hospitals have installed a bedside bar-code system, even though there is mounting evidence that the technology combined with a comprehensive medication management system can substantially reduce medication errors and improve overall patient safety.

So if bar-code technology is valuable, why aren't more hospitals adopting it? Well, for one thing, it's costly. A typical system can cost thousands of dollars per bed. In addition, some systems just aren't that user-friendly.

Nevertheless, that hasn't stopped vendors from aggressively pitching their systems to hospitals that are under tremendous pressure to address patient safety concerns.

Currently live in three hospitals, with installation under way in six others, intelliDOT's CAREt system can scan conventional bar codes as well as small dot-like symbols. End users can scan a bar code or an information-rich iDOT symbol to access critical patient information. The CAREt handheld scanner employs wireless technology and is linked in real time to the hospital's clinical IS system. The system also provides drug interaction and allergy alerts prior to pharmacy review.

The cornerstone of intelliDOT's documentation system is the MedDOT technology. The proprietary fingerprint-like symbology is only 5 mm in diameter and, according to company officials, can hold far more data than a typical bar code. The symbol's design allows it to be scanned upside down or sideways. Hospitals usually license the CAREt software from intelliDOT and pay related hardware and installation fees. The cost of the system is about $500,000 for a 200-bed facility.

David Swenson, R.Ph., COO of intelliDOT, told Drug Topics that CAREt is more user-friendly than typical systems that rely on standard keyboards or personal digital assistants operated with a stylus. "We designed it to be a one-handed point-and-document solution for nurses at the bedside," he said.

The concept for intelliDOT came about as a result of focus group feedback from nurses who were asked what they needed in a handheld scanner. "They needed a product that would integrate into their process better than carts and PDAs," said Swenson. He also said nurses wanted something they could use with one hand, freeing up the other hand to work with the patient.

The CAREt system was deployed at Stillwater Medical Center in Stillwater, Okla., in March of 2004. According to director of pharmacy Bill Arrington, R.Ph., in the first five days that the CAREt system was up and running, 10 medication errors were prevented. In the past, Stillwater used a bedside point-of-care system that featured a laptop computer mounted on a pole that nurses wheeled in and out of patient rooms. The intelliDOT system, he said, is more efficient and practical. "This handheld device is much easier to use, and the documentation is really good on the electronic medical administration record [MAR]."

Industry observers contend that with more and more bar-code offerings becoming available, hospitals should choose systems carefully and expect some sort of trade-off. "Handheld devices with small screens are easier for nurses to transport to the point of care than the COWs [computers on wheels], while, on the other hand, larger screens are easier to read and present more information than handheld options," pointed out Mark Neuenschwander, a Bellevue, Wash.-based technology expert. He said that hospitals should carefully think through what they are willing to give up against what they may gain in the technology that they ultimately choose.

Swenson said that bar-code medication administration (BCMA) is a complex undertaking and that some vendors spread themselves too thin trying to address the needs of multiple departments within a hospital. He believes a customized solution is the best strategy. "No vendor other than intelliDOT uses customized hardware for its BCMA system. All use an off-the-shelf laptop/cart or PDA."