Conformance Levels

RXD-35, RXG-25, RXA-25: new Fields and cardinality for Barcodes

V 2.8 HL7 Proposal
Change Request ID: / xxx
File Name: /
xxx CX barcodes v02.doc
Description: / Add fields, adjust length and cardinality of barcodes
Status: / Proposed for Orlando
HL7-Version / 2.8
Chapter/Section / 4.A.4.5
Sponsoring Person / Frank Oemig
Sponsoring Business Unit / Agfa HealthCare
Date Originated: /
18/05/11
Date HL7 approved:
Backward Compatible: /
yes
Forward Compatible: /
yes
HL7 Status & Date / to be reviewed during May 2011 WGM

Justification Detail

In different scenarios it becomes important to communicate the identifiers for something which is represented as a barcode or as another automatic identification technology.

One typical case is when a pharmacy receives for example a few products, all of them Aspirins, expiry date 21-12-2012, Lot L0001, and with a barcode tag string BBBBBBBBBBB. After adding them to the pharmacy inventory (including scanning the barcode), the pharmacy system sends an inventory message (MFN^M16) or delivery report (RDS^O13) saying "I have received these products, with these characteristics. Whenever you scan barcode string BBBBBBBBBBB, you are scanning Aspirins ending on that date"

The receiving application, (e.g. at the nursery), then knows that whenever the string BBBBBBBBB is received from her scanner, the product that is being scanned is an aspirin with that lot and expiry date.

The same applies when an (automated) medication dispenser prepares medication for a patient:

When printing the packages, the system also prints a unique, serialized barcode. It then sends a dispense report (RDS^O13) that says that “The medication XXXX with the characteristics WWWW has been dispensed for patient AAAAA, and the barcode B2B2B2B2B2 has been assigned to it”.

The nurse, while administering medication for a patient, scans the barcode, and the system is informed that the unique number B2B2B2B2B2 refers to that medication for that patient.

So, every time an aspirin is used, instead of selecting it on the computer (which is more prone to human error), the people manipulating the product can simply use the barcode scanner to facilitate data entry and increase reliability of the entered data, focusing more on the care or operational activities, not on the systems.

These two cases above can coexist – a product may have two barcodes, one “official”, one “internal”. Or even more.

The same applies to e.g. RFID, as an RFID tag has a unique serialized identifier that the different readers throughout an institution should know what item it is assigned to.

Since each product can have multiple machine-readable identifiers, a repeatable item identifier should exist to support this.

The proposal is to add this field as RXD-35:

35 / (1..999) / EI / O / Y / 9999 / Dispense Barcode Identifier

RXG:

The medication preparer, like a nurse or semi-automatic system, can tell the nurse that “for the 8.am administration event, the medication that has been assigned and available at the patient bedside has the barcode BBBBBBBBBBB. The nurse should scan the correct barcode, to ensure that the right medication is being administered.

At the same time, if a message is sent to the pharmacy, the stock management system will know, from the barcode, which specific item was consumed (from the product code or lot number alone this may not be possible to determine).

Since each product can have multiple automatically-readable identifiers, a repeatable item identifier should exist to support this.

The proposal is to make the barcode identifier field repeatable and adjust length in RXG-25:

35 / (1..999) / EI / O / Y / 9999 / Give Barcode Identifier

RXA:

Since the nurse may report that “I have just scanned this barcode, which identifies the product code, charge number, etc, and which specific unique product I have used”. In this case the stock management system will know, from the barcode, which specific item was consumed (from the product code or lot number alone this may not be possible to determine).

The proposal is to make the barcode identifier field repeatable and adjust length in RXA-25:

35 / (1..999) / EI / O / Y / 9999 / Administered Barcode Identifier

Since each product can have multiple automatically-readable identifiers, a repeatable item identifier should exist to support this.

EI seems to be a more appropriate data type, since it is an automatically generated code, and each code will be associated with a physical item, not an item type.

CWE Can also be used, if length limits are consistent with the long barcodes existing today.

It is impossible to have a fixed limit, e.g. QR Code support 700+ digits, other codes are variable length.

Outstanding Issues

V3 Implications

This concept can be applied to V3 as well.

V2 Implications

none

v2.xml Implications

none

2