An Alternative Machine-Readable Coding Scheme for Unit Dose Medications

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Presentation. Quiet Safety Depends on Verifying the

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An Alternative Machine-Readable Coding Scheme for Unit Dose Medications Presentation to the US Food & Drug Administration July 26, 2002 Presenter: Stuart Creque VP, Business Development (510) 302-3463 ext 204

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Presentation Patient Safety Depends on Verifying the "Five Rights" of Medication Administration Quality Depends on Measurable Systems Bar Codes and the Bad Trade-off Bar Code Legacy Systems: What Do They Have in Common? The Answer: a Linking Code Comparing Med Dots to Bar Codes The Med Dot Patient Safety Solution Architecture & Its Advantages Cost Advantages Licensing Med Dots Industrywide

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"Five Rights" of Medication Administration Right patient Right pharmaceutical Right dosage Right time Right course – conveyance technique (oral, infused, and so on.) and site (right or left eye, and so forth.)

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Quality Depends on Measurable Systems The estimation of the framework lies in confirming 100 percent of prescription organization activities and recording (measuring) each one of those activities Measurement is basic to consequent main driver examination and other systemic ways to deal with blunder avoidance The estimation gives a denominator to compute genuine mistake rates Every patient guardian (RN, LVN/LPN, and so on.) must have an approval and estimation apparatus

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Bar Code-Based Approaches Data about medicine is inserted in the code Implies producing & printing codes on the fly New information prerequisites = new codes on bundles More information = greater code Still requires query from database to contrast substance of code with drug arrange

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The Bad Trade-off of Bar Codes Symbol estimate versus cost of hardware 1-D (customary) standardized tags require huge bundling range Increases expenses of bundling, stockpiling, transportation Require laser scanners for most extreme unwavering quality and comfort RSS or 2-D (framework) codes require less bundling territory Decreases bundling & related costs Substantially builds framework execution costs because of more advanced, costly perusers

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No Good Answer with Bar Codes With conventional scanner tags, bundling costs (counting retooling creation lines) deter producers and doctor's facilities experience issues advocating tolerably costly standardized identification perusers If the maker tries to lessen bundling costs utilizing RSS or grid codes, the clinic is even less ready to bear to actualize the framework because of the restrictive cost of the code perusers

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The Bar Code Legacy Vendors Baxter (Deerfield, IL) – Autros™ Becton, Dickinson (Franklin Lakes, NJ) –™ Bridge Medical (Solana Beach, CA) – MedPoint™ Cardinal Health (Dublin, OH) – Pyxis division – VeriFive™ McKesson (San Francisco, CA) – Horizon Admin-Rx ™ Siemens Health Services (Malvern, PA) – Med Administration Check

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What Do They Have in Common? All offer comparative arrangements All utilization 20-year old modern standardized identification innovation Total piece of the overall industry is 3% The weaknesses of scanner tags trade off patient wellbeing: 97% of US healing center patients don't have security against bedside prescription mistakes

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The Answer another code image and peruser with these perfect qualities: A "connecting code" that connections the pharmaceutical to a database section that can be progressively refreshed Large code space: each measurement of each medicine gets an exceptional serial number (basic in the period of genomics) Small size: fits onto financially estimated unit dosage bundles with close to nothing, assuming any, upgrade Low-cost peruser: furnishing each patient guardian with a code peruser is moderate Ease of operation: doesn't require cautious arrangement, broad programming preparing

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Advantages of a Linking Code Static data (e.g., maker, NDC number, part, termination date, and so on.) can be added to database whenever Codes can be pre-imprinted on bundling material, then related to particular item/plant/line/parcel/date data in the wake of bundling run Dynamic data (e.g., deals history, drug arrange points of interest, apportioning history, organization subtle elements, genomic customization, parcel reviews, and so forth.) can be followed for every individual measurement Same code image can be utilized to recognize quiet, parental figure, port on IV or other line, and so on. Same code image on printed material and frill cards licenses programmed diagramming, documentation, charge catch, and so on

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Med Dots v. Standardized tags Bar codes are feeling the loss of these five basic elements: Enlarged Med Dot Small — 5 mm width Reliable — Forward Error Correction; round shape can be perused at any point Low Cost Reader — an individual peruser can offer for under $100. Scrambled — one of a kind and encoded Huge Code Space — 500 one of a kind Med Dots for each individual on Earth, each day, for a long time

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Functional Comparison Existing Approaches Med Dot Solution Cost Wireless Med Dot perusers cost $100. Standardized identification perusers cost $300 to $1150 each. No new system required. The remote connection is immediate to the medical attendant's station PC—30 foot run, in 900 MHz ISM band.Minimal preparing required. Different frameworks require costly and conceivably meddling 802.11 healing facility wide remote system. Broad preparing required. Simplicity of Deployment 1-D scanner tags are 20X circumstances bigger and require auxiliary medication bundling to hold the substantial standardized identification mark. Little (5 mm), round Med Dot fits on unit-measurements bundling. Similarity Dedicated remote Med Dot peruser weighs 1.25 oz. Shirt-take agreeable. No console. No docking. Programmed information synchronization and recording. Modern standardized tag scanners weight 8 oz to 2.5 lbs. Frequently should be connected delicate PDA. Different strides are required to check a standardized identification. Convenience Each Med Dot is one of a kind to a solitary dosage for a solitary patient. Averts mishandle, and tracks blunders to the reason for the mistake. Existing frameworks frequently miss key rights, (for example, exclusion, mishandle, or wrong time) since standardized identifications are not remarkable nor particular to understanding. Security All Five Rights Med Dots normally fit into charging, requesting, and other healing center applications. Standardized identification frameworks are constrain fit into different applications inside the healing center. Expandability

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Med Dot Patient Safety Solution Med Dots in a Patient Medication Safety System Medications are set up in the clinic drug store in unit measurements. Each measurements is set apart with a "Med Dot" (special machine-clear code) The attendant taps the Med Dots with her "Dab Finder" (smaller remote peruser) The electronic Dot Finder gives moment approval of every one of the five rights. The framework consequently records subtle elements of medicine given (patient, nurture, time, tranquilize, dosage, course, notes)

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Solution Architecture Computer Physician Order Entry Med orders Pharmacy System Nursing Station PC ftD Pick list Order information, Tap information Med-Five Server Med Dot Lookup Med-Five RF interface Dot Database Pick list w/Dots MAR w/Dots Med Dot Reader Med & Tap Data Content & History Database Printer

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Architectural Advantages Med Dots can be "layered" on top of existing drug store data frameworks without broad reinventing The Med Dot layer "tunes in" to prescription requests after they are checked by the drug store framework, as they are transmitted to the nursing unit The Med Dot distinguishing proof and approval layer adds abundance and specificity to solution orders Med Dots can be consolidated effectively into existing bedside confirmation arrangements

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Code Printing Cost Advantages Med Dots can be imprinted on existing bundling with minimal peripheral cost No costly retooling of bundling lines for "on the fly" coding No bundling material added just to print codes Potential investment funds of many $millions yearly Affordability and simplicity of usage mean more noteworthy take-up by makers and more all inclusive accessibility to healing centers

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System Cost Advantages Med Dot innovation is substantially more moderate for the doctor's facility Equipping 2.4 million RNs, LVN/LPNs, CNAs with Med Dot perusers spares between $500 million and $2.5 billion contrasted with standardized tag scanners Equipping 5,800 doctor's facilities spares a few $billion more in diminished framework execution costs Affordability implies more general use and better, more far reaching security of patients

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Implementation Industrywide findtheDOT will permit Med Dot printing innovation at negligible cost (i.e., no per-bundle eminences) to each pharmaceutical & biologic item producer and packager findtheDOT will permit any intrigued maker to deliver Med Dot perusers findtheDOT will permit any intrigued frameworks integrator to use Med Dots for patient wellbeing Licensing expenses will be utilized to keep up a focal registry of Med Dot codes for the business

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Making a Real Difference "findtheDOT's innovation can possibly drastically decrease therapeutic mistakes and accordingly increment the nature of patient care." — Dr. David B Nash, MD, MBA Dean and Director, Jefferson Medical College Advisor to findtheDOT Med Dots will spare many lives and billions of social insurance dollars every year.