How a Barcode Technology Application Helped MUSC Health Reduce Medication Errors and Spur Further Innovation

Medication errors are extremely costly, to both the patient and the healthcare institution. See how the Medical University of South Carolina (MUSC) used a QuickBase sandbox environment to build new technology to combat errors and rally administration support.

Electronic health record (EHR) systems are changing the way care is administered in medical institutions around the world. They provide clinicians the ability to seamlessly hand-off patients by offering real-time data that ensures continuity of care. However, at the Medical University of South Carolina (MUSC), we observed that EHRs also introduced new types of errors, specifically, barcode medication errors. 

As part of the Medication Use Policy & Informatics team at MUSC, it’s my duty to mitigate these types of errors. My challenge was to make sure that the incoming inventory of medication was screened and validated, to ensure that it would be correctly recognized by our health system from the moment it arrived at our facility to the point of administration to patients. The pharmacy would act as an intermediary, responsible for identifying medication barcodes to ensure they matched the data in our IS systems. 

Before we used QuickBase to build our own barcode validation software, we—like most health systems across the country—relied on managing by exception through self-reporting, which meant we were addressing barcode medication errors in a reactive manner. The inability to manage proactively created a gap in our medication use process, which is what prompted us to take action and create a system that was highly functional and could be used to parse and manage medication data on a daily basis.

First, we knew we needed to do a wholesale scanning of all our inventory. Collecting this data was the first step in getting organized. We started by having our pharmacy technicians, who are the main inventory procurement personnel, scan the barcode of each and every medication on a daily basis. This rudimentary process was a good start, but it was highly inefficient, often taking an hour to an hour and a half of each technician’s day across multiple sites. In addition to this, there was an added time cost incurred for the Pharmacy IS team when it came to identifying and resolving issues.

To improve on these inefficiencies, we decided to implement an QuickBase sandbox, where we created a form with a standardized set of values that would allow technicians to report medication issues, as well as note the product identifier tied to that specific medication, and request assistance. Next, we began to create a way to manage these issue requests. For example, we created a queue that handled tasks by priority. Once we were able to manage tasks, we started seeing where we could further streamline the various processes, repackaging bulk products, for example, that branched off from the main processes. This further streamlining was an unexpected side-effect that proved very beneficial. 

Once we’d created an application in the sandbox, we realized we had been able to accomplish something no other medical institution had ever done before. Our system was novel, in that it included a tool which enabled not only the notification but also the two-way communication of users. What we decided to do next was to build an application that would integrate data and interchanges. We were able to leverage data from our vendors, like McKesson, Omnicell, and Epic, to create a custom web-based application that solved a widespread problem that no one else had been able to remedy until now.

We couldn’t have done this without the safe environment provided by the QuickBase sandbox. That was the catalyst that spurred the innovation. With the data leveraged from the QuickBase app, we were also able to identify and quantify the issues and impact of the errors we’d discovered. The data spoke both to issues around patient care, as well as to the financial impact to the health system. This information was then provided to stakeholders. We needed their buy-in so that we could continue our work, and take this application from a prototype to implementation.

As anyone in a major health system can attest, whenever you try to introduce a novel approach or a new process, the most common feedback you will hear is “no.” Vendors spend years developing their products, applications, and systems, and rarely want to commit to producing a new application for one customer. Leadership says no, because they’re often concerned with time and resources being spent, but with QuickBase, we were able to bring the necessary data to life that allayed leadership doubt. We provided irrefutable evidence, demonstrating that not only were our proposed innovations possible, these innovations would actually ensure safety and have a major financial impact.

Without QuickBase and the ability to create this application in a sandbox environment, we would have never been able to get past the very first no, and we would still be manually managing our information systems and inventory received from the pharmaceutical supply chain, and addressing issues reactively rather than proactively. 

As a result of our continued work, we’ve achieved various successes with our new system. Since connecting the new application with our three main EHR systems—Epic Systems, Omnicell Connect-Rx, and Baxter DoseEdge—we’ve been able to drastically reduce our volume of requests, and almost instantaneously see a steady decline in lead time for our production personnel, as well as from our repackaging requests. The savings from those results alone have been more than enough to justify our work. Even more important, this savings gives us the ammunition to get the necessary funding to continue to innovate.

With this new technology, we’re going farther than we ever thought possible. For example, many health systems have implemented barcode technology and the infrastructure that surrounds it, but our technology has identified gaps in the supply chain even before the medications arrive to our front door. Identifying those gaps allows us to correct course and thereby eliminate the issues that would have cropped up if we’d allow those gaps to enter and continue downstream through the system. 

QuickBase was instrumental in providing our team with a safe environment to build something truly innovative. It also helped us generate the data we needed to keep the project process optimized, on-course, and ultimately, bring it to fruition. Perhaps most importantly, with QuickBase, we got the results we needed to more than justify future innovations.