Drug barcode guru and gadfly talks FDA rules and IV robotics

Mark Neuenschwander is founding director of the THRIV Coalition. He is a longtime patient safety advocate and academic responsible for hospital barcoding and other initiatives. He and THRIV now are focused on IV robotics.

Neuenschwander also is in part responsible for the FDA Bar Coding Rule and says pharmacy automation in hospitals is the next phase of his work.

Technicians preparing IVs, pharmacists checking techs’ work and nurses hanging bags cannot verify contents simply by looking at the fluids. Nor do they have tests for confirming that the doses were accurately prepared. Only automation can ensure one removes the element of human error in providing patients the right drugs at the right dose, Neuenschwander says.

Neuenschwander sat down with Healthcare IT News to discuss the FDA rule, IV robotics and reducing errors during the IV process.

Q. You are in part responsible for the FDA Bar Coding Rule. Please explain what healthcare provider organization IT leaders need to know about it.

A. Well, I was one of a chorus of voices. For sure, mine was among the more unrelenting. Some have suggested that I was to the [bar coding] cause what Ralph Nader was to seatbelts laws – a gadfly that refused to go away. But I was not alone.

At a 1995 pharmacy conference, I observed a tabletop model of a multi-axis, bar-code-literate robot designed to automatically pick custom bar-coded medications for patient cassettes in hospital pharmacies. They were designed to retrieve meds more efficiently and accurately than humans.

In what seemed to me at the time a throwaway line, the developers noted, “One day, because of the robot’s bar-coded packaging, hospitals may someday be able to scan patient wristbands and medications for a match at the point of care.”

His words arrested my imagination and changed the trajectory of my life. Enough that for more than two decades the license plates on my car have read BARCODE.

Interestingly, the barcode was invented in 1948 – the year I was born. Growing checkout lines induced by post-war prosperity nudged the grocery industry to find technologies to speed customers through their lines. Their research also revealed high rates from cashiers manually keying in numbers and decimals.

Industry leaders were led to believe that newly imagined electronic-code readers might help in fulfilling their vision. Except, barcode readers were nowhere near small enough to integrate with checkout stands.

Not until 1974 was the first retail product scanned. Even then it took another 10 years before barcode scanning was ubiquitous in grocery stores. The main barrier? Product packaging arrived on loading docks without barcodes, requiring stores to manually apply barcoded stickers to each item.

This was labor-intensive and error-prone. Eventually, to the delight of grocers, manufacturers began voluntarily applying barcodes at the source – once they discerned grocers were giving priority to purchasing coded over non-coded items.

By 1985, virtually everything landing in grocery stores arrived with barcodes. Within another five years, barcodes had moved into all retail, showing up on toothpaste at drug stores, screwdrivers at hardware…