Chris Tucker, RPh, Director of the Veterans Health Administration (VHA), recently explained that the facility received its inspiration for developing a bar-coding system of its own after one of the nurses returned a rental car. The nurse observed one of the employees of the rental car company using a handheld electronic device to scan a barcode that was located in the rental car’s trunk. This observation gave the nurse the idea to use the same type of application to identify patients and medications.

The Department of Veterans Affairs afforded a start-up fee of $50,000 for the development of a barcode system to help the facility administer medications more efficiently and improve the overall safety of the facility’s patients. The prototype that resulted from these efforts was wireless, real-time, POC technology designed with an integrated barcode scanner to be utilized at twenty-two nursing units inside the VA’s Eastern Kansas Health Care System.

This prototype became the VHA’s catalyst for the creation of a system that could be utilized at every VHA medical center throughout the nation. Its resulting Bar Code Medication Administration (BCMA) system was created for validating medications, as well as electronically documenting the administration of the medications. The BCMA was specifically designed so that nurses could scan the barcode of any ordered medication and tell:

  • Whether a particular patient received the right medications
  • Whether or not the dosage was correct
  • The scheduled time of the medication’s administration
  • The actual time each patient is given the medications

The BCMA system was integrated into the pre-existing nursing and pharmacy software programs that were currently in use by the facility staff. Historically, these two separate facility departments had not worked together cohesively in addressing patient drug administration and/or delivery problems. Being able to standardize drug order guidelines effectively facilitated a more efficiently coordinated process for ordering and delivering medications.

A pharmacist consultant for the VHA, Ron Schneider, said that a multidisciplinary team made up of pharmacy, nursing and information management specialists was a critical factor in the installation of the BCMA system. He noted that fully understanding everyone’s working conditions, coupled with collaborative efforts, is what improved the implementation process of the BCMA system.

Presently, all VA medical centers are now reaping the benefits of using BCMA. Between 1993 and 2001, there has been a considerable reduction in dosing, patient, timing and medication errors. In 2002, BCMA Version 2.0 was released, which featured a series of checks and balances for IV therapy.

The BCMA project has future goals of interaction with other clinical software systems that contain information on nutrition, vital signs, and lab results.

And to think, it all started with a nurse returning a rental car.