Andrew Raynes is the Chief Information Officer at Royal Papworth Hospital and the digital lead and chair of the Cambridgeshire and Peterborough Digital Enabling Group across the ICS.
We spoke to Andrew about the major barcoding project he’s currently working on and how it stands to revolutionise the way care is delivered to patients in the NHS.
Barcoding is by no means a new development. Used on packaging for the best part of 40 years now, barcoding has been used to trace ingredients and components to their source to great effect. Barcoding in a healthcare setting is, however, a relatively new application of this well-established technology.
So how does it work for the NHS? To help explain that, we have to return to a scandal that many would rather forget – the horsemeat scandal.
“In that event, barcoding enabled the detection of horse meats, because the barcode identified where it was produced, the farms it came from, and therefore, you could actually discover the route back to its origins and understand what had happened.”
In a healthcare setting, the same logic would apply.
While pilots differ between sites, most involve tracking both patients, through barcodes on their wristband, and medical supplies.
The supplies cover everything from medication to surgical tools and implanted devices, such as a replacement hip or a cardiac monitoring device.
The barcodes on the patients and the devices can be scanned to track exactly which staff was involved in administering a treatment or used a device, and when and where that occurred.
The code can also carry additional safety information about the item, such as the use-by-date, reducing human inventory errors and improving stock management.
If a device, such a screw in a hip replacement or breast implant, developed a fault years later, the barcode can be used to trace its history and, ultimately over time, measure which devices are more effective.
“Why would you not use a technology that reduces the chance of never events, produces efficiency, and enables you to spend less time looking for things while also creating huge safety benefits?”
We asked Andrew to explain a few of the current applications of barcoding he’s seen deployed across the NHS.
At Royal Papworth, GS1 is deployed as their standard for barcodes. This gives you a string of information that gives you particular data about where the scanned item belongs and where it’s come from. This makes looking for something in a hospital really easy or tracking things down.
“We’ve got readers in the ceiling whereby if say a wheelchair or a patient with a patient wristband on goes under the ceiling reader, that reader takes a breadcrumb trail of that patient or that individual piece of equipment that has passed through that gateway. It records that into a computer system and enables us then to create a breadcrumb trail of where equipment moves.”
Medical equipment is crucial to the NHS and the wellbeing of it’s patients. However, maintenance of that equipment is proving to be a challenge.
In the last five years, 66 trusts in England have spent over £14m on 560,000 walking aids but just 67,000 were returned by patients and more than 240,000 walking aids went missing.
According to data obtained in a freedom of information request by the PA, around 3,000 walking aids were returned to trusts in such bad condition that they had to be scrapped altogether, costing them millions of pounds.
This is just one example of medical equipment that cost a lot and needs to be tracked responsibly, barcoding, however, has the potential to make the tracking, tracing and retrieving of most medical equipment including critical systems like ventilators.
“This technology enables us to track and trace where that equipment has gone, minimising spend on new equipment and lengthy location projects.”
It goes without saying that you want medical professionals spending less time on administrative tasks and more time on patient care. However, due to the critical nature of this equipment, someone needs to manage it. Oftentimes, that administrative load falls on the last person you want it to – the front-line caregiver who will have to do audits.
“Ward equipment audits can often take up an entire day. Using this technology, it takes less than half an hour.”
Say, for example, a patient comes in for a hip replacement. That replacement might arrive at the hospital and be scanned immediately. This will tell you that it’s a hip, it has three screws and that is recorded in the computer system where it stays as a digital breadcrumb.
When it comes to surgery, the surgeon will scan themselves and the patient will be scanned. This is included on the same record as the hip, creating a complete audit trail that has happened in real time.
Before closing the patient up, because this trail has been observed, there is then an opportunity to scan the patient for foreign bodies that may be at risk of being left behind – an example of something commonly referred to in the NHS as a Never Event.
“It’s our Hippocratic oath – first do no harm. This technology is doing exactly that. So, wherever you’re required a patient to have a physical presence by coming to a hospital. This time kind of technology is critical. And so that’s why when we built Papworth built the new Royal Papworth Hospital, we built it with that kind of technology in mind.”
Stock and supply management is another area that Barcoding can revolutionise.
When, for example, a box of medicine is delivered to the hospital, it can be scanned setting it’s authenticity, arrival date, hospital location and shelf life in the system where it’s added to a running inventory. This cuts down over-ordering dramatically while also lower the risk of using products that are out of date.
Andrew is the Senior Responsible Officer (SRO) of the GS1 Steering group at Royal Papworth Hospital.
This steering group was set up as a result of the Scan4Safety Department of Health Initiative and they’re driving the infrastructure needed to enable technology like that currently used in Royal Papworth.
Made up of clinicians, technology specialists and government officials, the steering group provides Andy and those interested in digital transformation through Barcoding the opportunity to have consistent and valuable digital transformation conversations and concepts.
Trying to keep up is the challenge.
“People are getting bitten by the bug. Use cases mean that clinicians want to do this, and then others want to apply this technology. And that, I think is where you’ve got to be careful is just making sure you’ve got the right questions lined up in terms of what are your biggest yields? and dressing it from a problem’s perspective? So, this is our biggest problem. Are we now chunking these up so that we get these things delivered in the right order to deliver maximum impact and benefit?”
