2D Barcodes in Healthcare

Posted by Bill

April 18, 2009

It’s long been known that using barcodes in the healthcare industry has the potential to greatly improve patient safety. I’ve seen reports that claim numbers of 7000 – 100,000 people die and up to 1,000,000 are injured every year due to medical errors. I’m not here to validate or invalidate those numbers. It doesn’t really matter what the numbers are. Even one death or injury due to medical error is too many. There are serious problems in the healthcare industry if people are dying because of human error.

Barcodes are being used extensively in healthcare. And they do help reduce the the number of deaths and injuries. But many healthcare operating systems allow the user to bypass the barcode reading if there is a problem reading the barcode with the barcode scanner. It’s these types of system overrides that need to be addressed and improved upon. The barcodes are in place, now the underlying issues need to be fixed.

One area that is in need of serious improvement is the patient wristband. How many people get admitted to a healthcare facility per year around the world? It’s hard to find an exact number. Do a search in Google on the number of hospital admissions per year and the numbers returned are staggering. For every one of those admissions there’s a wristband being used. In the United States a typical wristband might look like this.
linear-wristband
Notice the linear barcode to the right of the patient information. It’s that barcode that gets scanned many times per day. When the patient gets transferred to another department for testing the bacode is scanned. If medication is administered the barcode gets scanned. There are many instances when that barcode gets scanned throughout the day.

These linear barcodes are very small and difficult to read, even when printed perfectly. Rarely have I seen one printed perfectly. Many of the printers simply cannot print perfect barcodes this small without constant maintenance. When the barcodes aren’t printed perfectly the barcode scanners cannot read them. When the barcode can’t be read the nurse or doctor must rely on manual data entry. With manual data entry comes errors. The healthcare operating system allows manual data entry as an override to reading the barcode. What can they do? If the barcode scanners can’t read the barcode the patient data needs to get entered somehow.

A new design for the patient wristband has been proposed and is being used in more and more healthcare facilities. The design looks like this.
2d-wristband1
You’ll see the original linear barcode is still present. But there is also a series of redundant Aztec 2D barcodes that cover nearly the entire wristband. Each Aztec barcode contains the exact same data. That means that no matter what position the wristband is in at least one of the Aztec barcodes can be read by the barcode scanner. If a patient is sleeping and the linear barcode is not visible the nurse would need to move the patient’s arm to read the barcode. Not with the 2D barcode. There will always be a barcode visible.

The 2D barcodes also have built in error correction meaning the barcode can be slightly damaged and is still easily read by the barcode scanner.

The only disadvantage is the Aztec barcode can only be read by a 2D barcode scanner. If the facility is not yet upgraded to 2D barcode scanners they can still use the older linear barcode scanner to read the linear barcode.

In summary the use of 2D barcodes on patient wristbands provides some real advantages over linear barcodes. It’s this type of thinking combined with the use of newer technology that will greatly improve patient safety in healthcare facilities.