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More BCMA Junk Science from a surprising source

04/11/2010

More Bar Code Medication Administration (BCMA) analysis research needs to be called into question.  In the latest Health Affairs has an article the value of Open Source VA software.  The Value From Investments In Health Information Technology At The U.S. Department Of Veterans Affairs.  It was done by the Center for IT Leadership at Partners Healthcare, where I have had the pleasure to work and followed CITL. These folks are world class researchers.  So it is a little surprising to me that the Bar Code Medication Administration value analysis is a bit lacking, calling in question the entire study.

Bar Code Medication Administration Value Modeling Analyses is available as an Appendix from a link in the Health Affairs article.

The three studies they used to assume a benefit of BCMA are the ones below.  Not a single one was peered reviewed and one has serious internal bias. This is very disappointing. 

·         Reference 8. Eastern Research Group. Impact of final bar code regulations for drug and biologic products.  December 11, 2003.

o   Unable to find this report.  In some references on the FDA site it looked more of a general bar code impact study.  Perhaps it is a meta-analysis, but unable to find this report anywhere.  I will contact the author to find out more.

·         Reference 11. Malcom B, Carlson RA, Tucker CL, Willette C. In: Veterans affairs: Eliminating medication errors through point-of-care devices. Annual Healthcare Information and Management Systems Society (HIMSS) 2000 Conference. Dallas, TX. April, 2000. 

o   A HIMSS ppt presentation?  While the quality is usually good, what are the odds that liberty and embellishment might have occurred in a HIMSS presentation? 

·         Reference 12. Yang M, Brown MM, Trohimovich B, Dana M, Kelly J. The effect of bar code-enabled point of care technology on medication administration errors. Bridges Medical; April 2001. 

o   This was done by a vendor that produced BCMA software.  This presents some serious internal bias.  I have 2nd hand knowledge that the first version of this study produced zero advantage of BCMA and never saw the light of print. So my assumption is that they studied it until they got the results they wanted.

Being the Massachusetts democrat, Kennedy worshiping, single payer advocate, tree hugging, Prius driving, Obama devotee, pseudo-academic, commie that I am, I love the concept of Open Source software.   After the Software Wars is a terrific book by an x-Microsoft exec that swayed my opinion to understand and really think that Open Source software has a chance.  I so wanted for this study to show how terrific Open Source software is.  Given the BCMA analysis, I really need to question the entire study.

 The analysis does not model how changes in practice, VA policy, or quality improvement programs related to the system might have impacted adverse drug events rates.  As written in this blog many times, this may be the true value of implementing BCMA and it not being the technology at all.

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