By Rita Rubin
Gannett News Service

Magazines have them. Milk cartons have them. Macaroni-and-cheese packages have them.

And in less than five years, all prescription medications and commonly used over-the-counter remedies could have bar codes on their labels.

Bar codes enable cashiers to tally up shoppers' purchases quickly, including non-prescription drugs. In hospitals, nursing homes and pharmacies, though, they would have a far more serious purpose: reducing medication errors.

If the Food and Drug Administration's newly proposed bar-code rule is enacted, it could prevent more than 400,000 adverse health events during the first 20 years it is in place, FDA commissioner Mark McClellan says.

"Many errors occur when the medication is actually delivered" to the patient, McClellan says. "It's that area where we think this is going to have the biggest effect."

Upon admission to a hospital that uses bar-code scanners, all patients would receive an ID bracelet bearing a bar code linked to their medical records. Every drug label would bear a bar code containing, at the minimum, its unique National Drug Code number, which identifies the medication, its dosage form and strength.

Before administering a drug, a nurse would scan its bar code as well as the patient's. The bar codes would verify whether a patient was getting the right drug at the right dose in the right formulation.

The American Society of Health-System Pharmacists, many of whose members practice in hospitals and nursing homes, says the bar codes also should include a medication's lot number and expiration date to protect patients from recalled or expired products.

McClellan's announcement March 14 of the proposed rule opened a 90-day comment period. He says he hopes to publish a final rule by mid-2004. The bar-code requirement would go into effect three years after that. Hospitals would not be required to use bar codes, but they would save $4.8 billion to $7.6 billion in record-keeping and reporting expenses if they did, the FDA estimates.

Some hospitals, including those run by the Department of Veterans Affairs, already use bar-code technology. They have seen their medication error rates drop more than 70 percent, according to the FDA.

In early 2002, 350-bed Danville Regional Medical Center, in Danville, Va., implemented Siemens Medical Solutions' bar-code technology hospital-wide.

The hospital bought 80 scanners at $2,000 apiece, but it will more than make up the expense by preventing lengthy hospital stays or even lawsuits stemming from medication errors, says Patsy Sublett, a registered nurse and senior clinical analyst for the Danville Regional Health System.

Sublett says bar codes prevented about 1,200 potential medication errors at her hospital last year. Common "near misses" include giving medication to the wrong patient or giving a dose when the patient just had one, she says.

"Our nurses tell us all the time that they know that the system has helped them," Sublett says.

Today, McClellan says, only two drug makers put bar codes containing information such as dose on their products, so hospitals such as Sublett's have to make and affix their own, in some cases.