Heal Thyself

In our September issue, Editorial Advisory Board member Laura Bix explained how standardized automatic identification could lead to more accurate healthcare billing. Her insight couldn’t be more topical.

An article on www.msnbc.com in late October claimed that errors in medical bills are becoming more common. Regardless of whether the article’s claim is true, within hours more than 70 readers posted their own tales of billing errors. Many described being billed for procedures that never took place. One reported being billed for a 12-hour morphine drip that was never administered. Another recounted being charged “$385 for maxi pads,” and still another for an epidural for what was actually drug-free delivery. And the topper—one patient was charged for her medication as well as all of her roommate’s medication!

Many readers argued that hospitals intentionally overbill patients. However, a number of healthcare professionals wrote in, too, sharing insight that points more toward human error. While some defended the billing system, some professionals wrote that errors are rampant. “I was a hospital billing supervisor from 1994–2002 and I can tell you that all hospital bills, of any length, have errors,” reads one post. “Nurses get into the business of nursing because they want to care for people. They are not the ‘paperwork’ type. [And] nurses make most of the mistakes.” Some even admitted to what could amount to fraud. “They do discount for those who do not have insurance and then order unneeded tests and procedures for those who do have insurance.” Of course, these are anecdotal postings that we cannot possibly authenticate. But they seem believable. How could a system relying mainly on manual recordings of procedures and drug delivery performed in stressful, crowded conditions be anything but riddled with error?

FDA was onto something when it started requiring bar coded drugs for hospitals. Medical errors are common, and they threaten more than public health. They are contributing to what some experts call the collapse of the U.S. healthcare system.

Regulations, however, won’t do the trick. Bar coding is still not widely used in hospitals, even after FDA’s rule, reports Bob Cornick, author of this issue’s Track and Trace column: “In fact, it is estimated that only about 15% of hospitals have adopted bar coding for patient identification because the inconvenience of carrying scanners around slowed down workflow processes.” I also suspect that not enough bar coded products are flowing into hospitals.

What the healthcare system needs is for ALL players—drug and medical device manufacturers, insurance companies, and third-party payers—to recognize the business value of products that carry bar codes or RFID tags or any other standardized means of automatic identification. Capturing the ID numbers of products used in hospitals can ensure right patient, right drug or medical device, right procedure, right test, right payee, right price, and right bill, among other rights.

Why should you as a packaging professional care about more accurate billing? Your companies are just some of many being blamed for the high costs of healthcare, as are insurance companies, doctors, and others. A more accurate picture of such costs would be a better way to identify the real culprits in escalating healthcare costs. Only then can the healthcare system begin to heal itself.

Daphne Allen


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