Healthcare environment and EAN Some government announce that they are satisfied with their healthcare expense. In reality, they usually have to face several problems that make a loss on their budget and have to invest a large sum of money to ensure the public healthcare service. In many cases, healthcare spending occupies a high rate in a nation's GDP. Eventhogh high tech healthcare equipment, medicine and other healthcare services occupy a high rate in healthcare, a large number in healthcare spending is management and hospital operation one. In spite of government's efforts to establish priorities for enhancing investment value or cutting healthcare cost, few methods can handle the hospital operational management effetcively. Some examples in this document show that how to save a signification amount in hospital's administrative and warehousing spending is a great effort to enhance the real supply and operation. Automatic data capture–ADC, eletcronic data interchange-EDI technologies, allocation and encoding based on EAN's standards has been approved in order to reduce cost, enhance operational efficiency and dramatically reduce treatment's mistakes. For instance in UK, Swedish, Spain, Denmark, Swiss, Singapore, Belgium, Austria and Poland, the approval of internationally interdisciplinary and specialized standards has been widely passed through bringing diretc benefits for patient in terms of cost reduce and effetcive caring process. Specialized standards minimize misunderstanding and ambiguity within communication and supply chain and Warehousing processes help enhance the saving cost and facilitating interdisciplinary communication. Ean items code system is passed through by the European Standard Committee effetcively minimizing risks due to misunderstanding product's information such as capacity , type, size and components. Within EAN system, healthcare products, location and services can be given a code as standardized barcodes. These codes do not contain any information but play the role of a key to access into the data related to particular objetc stored in computer's file. In addition to international EAN item codes, we also develop a standard communication system EDI (also mean EANCOM). EANCOM can be used in some companies which need exchange commercial data such as purchase order, invoice and delivery advice through eletcronic devices. This combined with EAN-128 create a barcode system in order to manage supply chain assembly, encode additional information such as cargo number, manufacture date, series codes and more information, provide device for tracking and other devices for warehousing management which the world health requires in a more and more complicated manner nowadays. As well as enhancing interdisciplinary communication in the warehousing process, EAN system bring effetciveness of hospital operation through supplying better services (reduce mistake, give right medication , making decision for better treatment (accurate patient allocation, accurate documents and quick testing result), enhance customer's satisfaction (internal and external), enhance productivity, reduce cost and many other benefits. Over 30 outries in all continents have based on EAN system for prescription allocation, etc. Moreover, the United Nation International Drug Control Programme UNDCP has passed an approval agreement for EAN system to ensure accuracy and timely tracking drug's recirculation all over the world. All of these enhance this system's high quality and reliability so that consumer can believe in international EAN and its encoding organization with continuous support from over 70 countries. EAN system allows hospital to control accurately medicine in inventory, for instance medicine encoded and labeled as EAN-13 barcodes and UCC/EAN-128. USE OF EAN STANDARDSSome standards of product allocation, service and location. Eventhough EAN number code allocation is non-signification and does not contain any information, it is established to control administrative system and ensure the uniqueness of number code system all over the globe. The most popular EAN number code structure for pharmacetical products is EAN-13. The versatile article code UPC-A managed by the Universal Code Council which is considered as an organization equivalent to EAN for North America, is a definitely compatible standard. EAN location code allocates functional location and items in hospital and medical institutes. Here once again, number codes do not contain any information but simply allocate a location in the simplest and the most apparent manner. These codes are mainly used in some EDI and barcode applications. UCC/EAN-128 numbering standards is used as a minor series dedicated for code 128 and established to display additional standard data of number code allocation. These standard include:
Allocating number of application is widely used in healthcare environment to allocate, trace, label date, measurement, reference and location. Mostly, application allocation number support and innovate warehousing and supply management. That European indicator introduction issues some provisions regarding to caution in medicine use, tracking healthcare equipment, accepting and composing the same provisions in other areas in the world enhance a considerable number of consumers using this standard. EDI Standards Due to EDI activities enhancing the number of consumers in EAN code organizations, it drives to the decision to develop International EDI standard based on EDIFACT. Nowadays, Communication instruction and EANCOM message has been widely used by manufacturers, retailers, pharmacy, hospital and medical institutes. Moreover, EDI group in European pharmaceuticals represented for EDI consumers in European healthcare tightly cooperated with International EAN in order to use EANCOM message during the healthcare warehousing. Specific evidence is presented in economical results and increased quality in healthcare services thanks to using message and standard mentioned in above examples. EMERGENCY HOSPITAL BELONG TO MEDICAL UNIVERSITY UTRECHT (AZU) - POLAND
BACKGROUND This is the only 300 basic beds expetced to work for 14/7 to accept patient from disaster. This emergency hospital is funded and tightly cooperated with Polish Defense Ministry. Normally, A medical institute has 890 pieces of hospital beds and is considered as one of the most well-equipped in Europe. In spite of healthcare equipment and profound specialists, the cooperation is still ineffetcive that chaotic situation can easily spread from disaster zone to supporting zone. The general result of the hospital is dependent on related information provision for the right people at the right time and right location. It is really a weak chain at the time of disaster when staffs do not have any ideas about what to do while a large number of patients rushes in – How many patients are there? Where? Who should be got priority? Those are all problems driving to the chaotic situation. Furthermore, staffs need to have a regular report to other wards related to giving medication for patients. It is also required to get information ready in case there is patient visitor or incoming call from patient's relatives. Due to time pressure, patient's shock or anger, the process of information tracking might not be implemented which can drive to permanent loss or fault to capture accurate information. In order to avoid this above situation and have full control over data flow about patient, a projetc board of hospital information technology wards of Poland EAN and Poland non-hospital have established a user-friendly system "Computerizing in disaster relief or ABC (Automation, Barcodes and Chaos). To ensure quick and accurate data input and minimizing mistake capacity, this system has used EAN/UCC-128 barcodes. The main mission of ABC system is to provide accurate information for:
Through personal computer network, the above data supply system is considered as the foundation for hospital to offer effetcive service and information about unusual situation, number of patients, drug and treatment condition and location available for patient in some necessary places in hospital. Being equipped with these facilities, doctors and hospital staffs can make a schedule and give patients treatment quickly and smoothly. HOW TO USE UCC/EAN-128 At the ambulance reception place, each patient will be given a ribbon with barcode UCC/EAN-128 and some application allocations are used to allocation patients. This barcode also create a comprehensive file which contains some necessary declaration forms with barcode information about wound type, emergency drug and treatment, locations of X ray cabinet, surgery cabinet and hospital bed. After classifying patient into priority levels, an operational staff ABC (a nurse, an administrative staff, no need for the presence of an IT engineer) will scan related information, which encourages all healthcare centers to accept and take care of patients. The final area (enthusiastic/ average/high /low care) and some hospital beds will be decided and allocated in front of each location. For patient is treated at different places, their ribbon and treatment allocation barcode allow this information to be displayed in all necessary places. By that way, this system facilitates to prioritize task and manage treatment in an effetcive manner. Detail information about patient name, age, address will be captured in next stages when already have a communication with the patient's relatives. WHY USING UCC/EAN-128 IN THIS CASE IS THE ONLY CHOICE. Besides some additional applications, using UCC/EAN-128 for a patient allocation can prevent mistakes occurred during the process of identification and treatment even when patient is transferred to another hospital; The reason is that this international allocation standard has been provided to be used in this special case. SENSITVE INFORMATION MANAGEMENT ABC system not only distributes information to treatment provider in a quick and accurate manner but also manage involved controller. For instance, a special group entrusted with special mission of patient's reception and treatment can contact outside specialists or ask to input drug from the outside through the warehousing service and order exact quantity of meal to the nutrition wards. For ABC system connetced with hospital's regular information system, information about patient can be easily available or delivered in case they need to be transferred to another hospital for further treatment. Finally, ABC system is really helpful for analysis and assessment on data capturing and treatment information. SOME DIRETC BENEFITS FROM USING THIS SYSTEM In comparison to the previous method (written information and person-to-person contact, it found that ABC system is overwhelmingly better than in terms of quantity and quality. The ABC system's operator can input a large amount of information of over 25% at the same time with the decrease of 25% in registry mistakes and a high speed data input. By this way, it can considerably reduce administrative time while enhance thermal conductivity and flexibility of hospital staff. Above all, it is ensured that there's no mistakes in the process of giving patient treatment which is a common problem occurred regularly at some emergency centers. FUTURE ABC system has attracted attention of both international and nationwide specialists. A reliable, quick and user-friendly data processing system encourages a further research to widely put this into use. This system is currently under consideration to be used to take care of normal patient in major hospital, disaster zone and some other hospitals through the use of desktop computer. In the future, it will be dedicated whether applying ABC system into wide use becomes reality or not. However, in Utrecht emergency hospital, ABC system has improved their value in making an improvement in drug use, healthcare and warehousing while accepting and giving treatment to a large group of patients.
EAN AT INSTITUTE OF CIUTAT UNIVERSITARIA DEL VALL D'HEBRON – BARCELONA – SPAIN
BACKGROUND Spain hospital system are built since 1960s which is featured by major hospitals (with 1000 hospitals or even more) mostly located around the capital. At that time, people did not pay as much attention to small cities. From the mid of 1980s, Spain healthcare system started to carry out a reorganization for a stable balance as well as enhance the offered service quality. One of a remarkable feature is that 65% capacity of hospital bed in Spain is under the control of the government, the rest is run private enterprise. Conventionally, there is distinction between healthcare service provider and their management. This approach facilitate for a better comprehensive management. Siutat Universitaria del Vall d'Hebron represents for a group of hospitals and state enterprise specialized in providing healthcare service including blood bank and primary healthcare center management. It has 2000 pieces of hospital beds including some hospitals mentioned below: General hospital, orthopedics and pediatrics ward. Moreover, it has blood bank, surgery units, microbiology ward, diagnosis institutes and radiation ward. The hospital's central service unit also provides laundry service, eletcric power station management, maintenance, supply chain, warehousing and other management service. Over 200.000 patients are annually under treatment with the surgical intervention. REORGANIZATION Since 1992, hospital has carried out reorganization for some key processes in order to provide better service for patient as well as reduce running cost. In addition to these activities, Information technology is also used to enhance offered service quality. The above targets are achived with the contribution of two significant events. Firstly, For EAN -13 interdisciplinary standard introduction carried out within the pharmacy industry in Spain in 1987, Farmaindustria take responsibility to issue drug business license and determine to integrate "codigo nacional" system into EAN-13 system. This event in combination with the event that almost other goods was already labeled by EAN barcode, facilitate control process over supply and warehousing management by using a simple allocation system and even through different shopping channel for various products. Secondly, some pharmaceutical product wholesaler can quickly handle to get attraction to Point of sale (POS) technology at some pharmaceutical agent and introduce eletcronic data interchange (EDI) and procession of eletcronic purchase order. That this industry got approached to this technology allows hospital to easily accept the new automated environment. Approval of EAN standards regarding to products allocation and communication message which helps remove the redundant decision-making process and time-consuming is the key in every renovation process. Conventionally, all suppliers will feel highly welcome as the hospital's supply chain department decides to use barcode system to control the output and input products. Using barcodes and automatic data capture technology as a portable data terminal and warehousing software for an effetcive inventory –based route has resulted in speeding up purchase order process and purchase order's accuracy and achieving benefit from the original investment. Along with EAN-13, the hospital also uses UCC/EAN-128 to control the warehousing process. Through UCC/EAN-128, the hospital is able to allocate transport container's series number, ballet capacity, quantity of products in ballet, production lot, product duration, gross weight, volume, producer and location. These products are very valuable to ensure quality, warehousing management and effetcive distribution. At present, Siutat Universitaria del Vall d'Hebron with the help from EAN organization in Spain will introduce EDI to the hospital and along with other healthcare centers play the roles of the projetc leader. There are 20 providers involved in the projetc including : 3M, Baxter, Boerhinger M, Brau Medical, Jonson&Jonson, Meranini, Molnlicke, Unitex Hardman, and El Corte Ingles. This group intends to definitely automates data flow and minimize human intervention into warehousing and shopping processes. EDI message relies on EMEDI instruction to use EANCOM for warehousing message and EAN-13 to allocate locations. BENEFITS
FUTURE Siutat Universitaria del Vall d'Hebron Insitute is satisfied with the result and bemefits achieved from the above automated process and EAN standard. Plan has been scheduled to extend these results for other hospitals in Spain.
APPYLY EAN LOCATIONBARCODE IN HEALTHCARE INDUSTRY IN DANMARK
BACKGROUND Denmark healthcare industry is considered as one of the most automated industry and best organized in Europe. Almost service providers of this industry has been connetced with internet and eletcronic data interchange (EDI), a common device. Currently, 15% of discharge letter, 7% of testing result, 10% of prescription at pharmacy were transferred by EDI and still under the process of further extension in the future. To enhance further communication within the industry, the government sets up a common national summary table system which is apparent and independent of communicative system and used for all EDI message. In spite of location barcode system, consumer's survey shows that it is required to have a common standard or in other words an international standard. Is it capable of getting rid of a variety of principles existing within the supply and maintenance process served for doctor, hospital, public healthcare institute and healthcare insurance organizations? After doing research for various coding schema, EAN system is assessed as the best with a provision of a system which can meet all requirements of this industry. Health department send their compliment to other industries such as transportation and retail for applying EAN system into an international environment in an effetcive manner for a long term. APPLICATION After establishing Secretary Board and assigning centralized management task for EDI activities, Denmark Health Department is given a range of 11.00 codes by Denmark EAN. Issuing location barcode is managed by Board of EDI. Moreover, Secretary Board is provided with all EANCOM/HACOM handbook, updated version and other additional information by Denmark EAN to ensure the projetc' result. To ensure the use of location barcode in varieties of communication, Secretary Board of EDI comes to a decision that these location barcodes will be used dedicatedly in EDI exchanges between General Practitioner-GP and pharmaceutical mills and hospitals. The main matter issued to be considered in the projetc is how to apply EAN system while still using other systems without corrupting all functions. This issue is especially severe because 30 existing software systems and almost EDI messages have been encoded by provider. All software have been approved for transferring EAN system, which dedicates that the "from" field and "to" field with 13 numeric character of the message and issue the check digit by EAN algorithm. At the same time, the sender's allocation code of data assessment is also inputted (Law compulsorily requires GP allocation code). In cooperation with the authorities and healthcare organizations, VAN and software providers has established a general working schema in order to transfer into EAN location system. VAN providers also agree to transfer the former location code into EAN and do a research of some potential issue occurring during transfer process. Location barcode is divided into suitable intervals in order to identify the sender and receiver in EDI address. 5 suitable intervals will be identified as below: EDI secretary Board, software providers, local authorities, general healthcare management, general doctor practitioner, healthcare specialist, drugstore, hospital, hospital's wards and units, pharmaceutical mills and the remain reserved for future. CRITERIA FOR AN EFFETCIVE APPLICATION A continuous information flow is essentially important to the projetc result. It is achieved due to constructive and positive activities carried mainly by representative of healthcare's organizations, software system, VAN providers, Denmark EAN and Secretary Board. Secretary Board and other partners are always making an effort to maintain, update and inform all involved parties of all changes in terms of location and users. BENEFITS AND FUTURE PROSPETCS OF EAN UTILITY The first and foremost advantage of EAN system utility is the capacity of addressing a wide variety of global partners in an apparent manner which is uniquely independent of the system and functionality. Moreover, Secretary Board of EDI as their central role has ability to complete and update information on all EDI activities within Denmark healthcare industry such as: EDI using objetc, the most common message being used, EDI using frequency, systems and standards being used for communication, etc. This system's effetciveness has considerably improved the offered service's quality served for Denmark publicity due to enhancing money received from taxpayers. In cooperation with Iceland EAN, a similar system is also under the process of applying in Iceland. The first and foremost advantage of EAN system utility is the capacity of addressing a wide variety of global partners in an apparent manner which is uniquely independent of the system and functionality. USING EDI AND BARCODES AT A.Z.ST JAN IN BRUGGE - Belgium
A few years ago, AZ.St Jan made a stragic decision to establish an eletcronic communication with pharmaceutical firms. Hospital took part in IBM projetc – "Hospinet" and this projetc failed for pharmaceutical manufacturers' low internet service. "It is in the same situation of an egg and a chicken" said F. Meuleman. "On the one hand, hospitals need to place an order for EDI in order to have a necessary presence of manufacturers; on the other hand, some hospitals don't want to have a technological investment as some manufacturers expressed that they do not appear willing for this investment. This hospital, however, is still persistent to make an effort until EDI Health, a non-profit organization was established in 1994 as a result of cooperation between manufacturers and hospital. EDI Health's objetcives are to help hospitals approve of EDI by providing original capital for purchasing equipment, standard software package and establishing lower-level software. WHY? A research regarding to pharmaceutical industry carried in 1992 shows that it takes average 10 days to deliver goods based on purchase orders in which 9% are not placed timely and 10% fall to the situation of insufficient delivery. In order to improve the situation, it was expetced that in 1997 through EDI the delivery period is 8 days following to purchase order, timely delivery up to 96% and insufficient delivery reduction of 5%. Even though EDI was considered as a device enabling to improve warehousing activity by reducing redundant time and minimize mistake, there is another decisive condition needed to be taken into account. Shopping organization, employees' activeness, mutual acceptance in terms of organization, good acknowledgement of common products are matters needed resolving. Effetcive EDI using requires organization to inspetc their own business processes and mutually organizational relationship. At hospital, warehouse storage level is specified based on necessary time to breakout packaged units into simple doses. To AZ.St Jan, at this stage the period of purchase order establishment is ranked at the low priority level. Some other diretc benefits such as reducing management time for purchase order processing can speed up the EDI system approval. Nevertheless, it takes time for the reason that 300 pharmaceutical providers have not been equipped with knowledge to handle the matter of paperless trade. Moreover, Meuleman feels that the existence of various codes is an obstacle for an effetcive EDI development. "In order to optimize the goods and information flow, it is extremely important to use a distinctive barcode from all partners, said Meuleman. "Each kind of medicine has its own code called APB (issued by Algemene Pharmaceutishe Bond) which is only used in Belgium but not popularly used in the whole world. Even worse, APB is not valuable in an integrated system for warehousing and individual units are allocated to the same code. Two bottles of medicine contained in a bundle for some reason will share the same barcode like two separate bottles. The matter raised here is how to identify a package of 24 pieces or a package of 2 pieces at the scanning spot by APB system. We decide to use EAN barcodes as we have got accustomed to using them and operating in the EAN barcode device system. EAN system, which is a device enabling to allocate the smallest unit, a delivery point and the entire system, will be an ideal device to save cost in hospital. In addition to communication capacity, this code also improves input goods tracking. Delivery advice is transferred by providers through EDI and goods deliverer can quickly check (when EAN tag's available) their specification and sufficiency. OUTPUT "Indeed, using EDI considerably reduced mistake, which is our major concern. In the future, the hospital effecicency will be enhanced when other prospetcs related to using renovated function device are taken into account. However, the most important is that at the primary stage, some immediate benenfits have been proved and hopefully continueing in the next steps as a better warehouse storage management system, Meuleman said.
USING EAN IN SWITZERLAND HEATHCARE SYSTEM
"Reglementation" concerns about safety and supply medication following to prescription in Switzerland and Liechtensten in order to bring benefits to patients and other objetcs within healthcare industry. Reglementation's objetcives:
In order to achieve this objetcive, Reglementation need to complete the following tasks:
In 1988, Switzerland EAN and Reglementation came to an agreement in which OICM's official registry code is presented as EAN codes. Since 1988, Reglementation released EAN code for almost pharmaceurical products to replace the previous pharmaceutical code. In 1994, Reglementation distributed EAN location code to all pharmaceutical manufacturers, import merchant, wholesaler, pharmacies, pharmaceutical mills and hospital in Switzerland. Moreover, since 1995 Reglementation distributed location code to all doctors (surgery) in Switzerland. By releasing EAN codes of all partners in pharmaceutical industry, Reglementation has established an essential foundation to apply EDI into this industry. The objetcive is to promote further EDI to manufacturers, wholesalers as well as the third business party. EDI projetc which in pharmaceutical industry called EDIPHARMA initiated in 1992 and used EANCOM message between manufacturer, wholesaler, and other business partners. Allocating product and location is definitely based on EAN system which can be found in Reglemention's database. Nowadays, beside 20 companies enthusiastically participating in projetc, next time many other companies are also willing to take part in this projetc. In 1995, the National Drug Control Agency introduced a new definition on the basis of EAN location barcode to allocate all involved parties in drug trading in Switzerland. Reglementation ensures that all involved parties will receive necessary information on allocation matter. BENEFITS By using eletcronic communication, automated data input technology and international standards, Reglementation reduced cost and enhanced offering service quality in healthcare industry. UTURE Having a tight cooperation with Reglementation, Switzerland EAN has extensively introduced EAN standards to other partners within healthcare system such as social security agency and hospitals to facilitate smooth information flow.
WAREHOSUSING APPLICATION INTO COMPANY
Like almost public organizations and some private enterprises, for a long time multinational pharmaceutical companies has developed EAN application due to its superities. However, this system is not limited to multinational pharmaceutical companies but some big and small merchants as well as healthcare equipment manufacturers (including national and multinational manufacturers) also took part EAN system's user association such as: HERBA APOTHEKER AG – AUSTRIA Since 1990, Austria pharmaceutical industry and Austria EAN have made an agreement to apply EAN codes and barcodes system into all products being used in Austria, which is carried out to meet demands of pharmaceutical manufacturers, wholesaler, pharmacies and social insurance organizations. Like Magister Odo Dobnig, Herba Apotheker AG's supply chain manager said: More than 50% prescriptions and pharmaceutical product tagged by EAN allows us to automate the process of product acceptance and distribution. About 100 pharmacies are equipped with POS scanning system with ability to possess some advantages of automatic inventory control technique by using EAN system and EDI order system to minimize defetcs and serve customer in a quick manner. According to Odo Dobnig: 350-450 products has met demands of over 50% income tagged by EAN Currently, pharmaceutical wholesalers and their suppliers has used EAN location codes and connetced with EAN Austria's EDI system in order to exchange purchase order, invoice and further enhance the process of distribution and warehousing in this industry. STRATEC MEDICAL- UK EAN/UCC-128's versatility completes EAN system and application allocating standards which are being used to provide healthcare equipment industry with international codes and EDI equivalent barcodes in order to meet their demands. Stratec Medical, an England agency under Switzerland Healthcare Equipment Corporation serves a healthcare equipment line of 7000 equipments with the orthomorphia equipment's turnover of 120 million EURO. In accordance with terms of Consumer protetcion law, this industry has to introduce Healthcare Equipment briefing on the 1st Jan 1995. This briefing's objetcive is to ensure healthcare equipment in safety for both patient and users. The advantage is that once getting approval, products can be purchased across Europe. "In accordance with quality assurance provisions matched with the briefing's requirements, we have an ability to return a product at any time as part of full tracking system. It is dedicated that we need to have inventory management system with ability of inventory tracking. After testing barcode standards in cooperation with other healthcare equipment manufacturers, we go ahead and introduce UCC/EAN-128 in 1994", Bob Smith - the legal manager of Stratec Medical said. "UCC/EAN-128 meets our legal demands on tracking any healthcare equipments from each manufactured batch to hospitals and enable us to take quick prevention actions or repairing in necessity", Smith continued. According to UCC/EAN-128 benefits brought from tracking are enormous. It help us accommodate with European Instruction, maintain only one system within the whole corporation and allows a tight FIFO (First in first out) inventory management and offer a specific diretcion to our distributors and Edi commercial preparation. |