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A Bar Code Case Study Steve Braun Today’s Presentation Why Hospira Implemented Bar Coding Program Management Customer Communications From Bar Codes to RFID Keys to Success Lessons Learned Plum ® Infusion System with positive valving PCA Infusion System

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today s presentation
Today’s Presentation
  • Why Hospira Implemented Bar Coding
  • Program Management
  • Customer Communications
  • From Bar Codes to RFID
  • Keys to Success
  • Lessons Learned
hospira advancing wellness through innovation

Plum® Infusion System with positive valving

  • PCA Infusion System
  • Omni-Flow® IV Medication Management System
  • National Hospital Pharmacy Quality Awards
  • LifeShield® CLAVE® Connector
  • Q2™ Monitoring System
  • LifeShield® needleprotection systemsintroduced
  • Plum® Infusion System added RS232 dataport
  • Bar-coded IV and injectable products introduced
  • Needlestick Prevention Systems web site launched
  • All unit-of-useinjectables andIV solutionsbar-coded
  • Carpuject® syringe technology acquired
  • Remote communication
  • ADD-Vantage® System
  • FirstChoice® Premix solutions
  • SAFESET™ Blood Sampling System
  • Label enhancements
  • Nutritional containers bar-coded
  • Ansyr® syringe
  • Q2™ Plus Monitor
  • Plum A+®Infusion System
  • LifeCare® PCA3 Medication Management SystemIntroduced with bar code IDof drug concentration
  • Plum A+® Infusion System with enhanced safety portfolio
  • ASHP medication error reductiongrants
  • Oximetrix® 3 Monitoring System
  • Continuing educationcourses for MD,RPh, RN
HospiraAdvancing Wellness Through Innovation

1980s

1990s

TODAY

the need to improve hospital patient safety

ADEs 6.5%

Potential ADEs 5.5%

1.8% are preventable2

Patients Not Exposed

The Need to ImproveHospital Patient Safety

7,000 deaths per year1

12% of Patients Exposed to an Adverse Drug Event (ADE) or Potential ADE2

1. Phillips et al, Lancet. 1998. 2. Bates et al. JAMA. 1995.

medication errors in the hospital
Medication Errors in the Hospital
  • 51% of hospital errors occur during administration1

1. Leape LL, et al. JAMA. 1995. 2. Leape LL, et al. JAMA. 1995. 3. Bates DW, et al. JAMA. 1995.

the promise of bar codes
The Promise of Bar Codes
  • Bar code-enabled systems have been shown to reduce medication errors

by 64.5% (at VA facility)1

by 71% (at North Colorado Medical Center)2

1. Malcolm et al. 2000 Annual HIMSS Conference. 2. Pucket F. Am J Health-Syst Pharm. 1995.

customer direction
Customer Direction
  • Group purchasing organizations
    • Contractual commitments
  • Wholesalers/distributors
  • Leading providers
    • St. Alexius
    • VA Hospital Systems
formed the bar code team

Manufacturing Plants

Regulatory Affairs

Graphic Studio

Materials Management

Label Control

Quality Assurance

Technical Operations

Engineering

Marketing

Formed the Bar Code Team

Hospira Bar Code Implementation Team

program plan
Program Plan
  • Over 5,800 packages: 1,200+ drugs
  • Committed to a standard; UCC.EAN-128
  • Began with corrugate
    • Low technical hurdles
  • Prioritized based on customer needs
  • Incorporated with any other label changes
  • 5 manufacturing plants
  • No financial justification
challenges
Challenges
  • Linear bar codes too large
    • 300 items too small for UCC.EAN-128
      • Including some of the most critical drugs
  • What standard would industry adopt?
  • Price increases unacceptable to customers
  • Unexpected issues (RSS)
    • Verifiers
    • Software
    • Packaging levels
rss technology
RSS Technology
  • UCC owned technology
  • Hospira is the first health care company to use Reduced-Space Symbology (RSS) to bar-code injectables and I.V. solution products
  • RSS allows all information to fit in an area as small as a pen cap
  • Trial run made in 2001 at St. Alexius proved readability
  • Expands opportunity for additional information
hospira bar code initiative
Hospira Bar Code Initiative
  • All injectables and I.V. solutions labeledwith bar codes at the unit of use

Ten-Unit Pack

Five-Unit Pack

Single Unit

hospira bar code initiative13

FDA proposed regulation announced March 13, 2003

Hospira initiative completedMarch 27, 2003

Initiative

announced

July 2002

Hospira Bar Code Initiative
  • Encompasses more than 1,200 drug and I.V. products
  • Critical mass for POC Medication Management System
  • Outstanding customer support and appreciation
moving beyond manufacturing
Moving Beyond Manufacturing
  • How do you know if a product has a bar codeon the label?
  • Where is the database of UPN numbers and corresponding NDC numbers maintained?Is this a validated system?
  • What product identifier does your customeruse to order product?
  • How are they linking the product identifierfor ordering with the UPN?
  • How do you make all product identifiers known to customers? How do you update them on changes?
electronic catalog
Electronic Catalog
  • Accessible from the corporate web site
product identification
Product Identification
  • Updated daily
  • May be downloadedinto spread sheet
radio frequency identification rfid

HostSystem

RFID Reader

Radio Frequency Identification (RFID)
  • Track and trace technologyvs. simple identification
  • Opportunity for:
    • Patient identification
    • Pump or other equipment locator
    • Drug or other expensive supply locator

Narcotics pose challengeto track and trace (control) today

from bar codes to rfid
From Bar Codes to RFID
  • Supply channel value initial goal
  • Customer and the FDA will defineimplementation timeline
  • Will have need for both technologies
  • EPC implementation required
  • Similar project approach
  • Shared/accessible electronic files required
keys to success
Keys to Success
  • Champion(s)
  • Team approach
  • Executive management support
  • FDA engaged
  • Network ofknowledgeable experts
  • Listen to customers
  • Frequent reviews
lessons learned
Lessons Learned
  • Education is important
  • Risk versus reward
  • Work with standards organization
    • Voice equals change
    • Build alliances
  • RSS software (new technology) may delay
  • Understand the market
  • Leadership brings rewards
hospira

Hospira

Advancing Wellness…

Through the right people and the right products