Daily Archives: March 14, 2008

Healthcare – Three Way Matching

Today I’d like to thank Vinnie Mirchandani of Deal Architect and New Florence. New Renaissance. for allowing me to re-post his thoughts on Healthcare – Three Way Matching as part of Healthcare Week.

At the HiMSS conference a couple of weeks ago, I had the privilege of having an industry veteran – Dave Watson – as a tour guide through the exhibit hall. He has years of experience at Baxter and Kaiser and is now CTO at MedeFinance, and it was a joy to hear his commentary on the technologies on display.

But at one point, he mentioned “three way matching” and I had to do a double take. Why was he talking about an age-old accounts payable concept of matching invoice with purchase order and receiving report?

The concept has been adapted in healthcare to reduce medication error with some slick new technology. The three-way match is across patient, prescription and care giver (whether certified to administer the medication) information. It involves all kinds of RFID and other sensors, bar codes, software to check on conflicts, and drug dispensers with their own controls built in.

How bad is the medication error problem? A recent study reported “One in every 10 patients admitted to six Massachusetts community hospitals suffered serious and avoidable medication mistakes”

So we saw the Motion C5 tablet.

Look at all the capture and communication technology it integrates:

wireless connectivity: to access patient information and physician’s order.

RFID: to identify patients, medications and assets

integrated bar code reader: to manage medicines or costly supplies

integrated digital camera: to take pictures and capture video for patient education and sealed design: wipeable for quick cleaning and disinfecting

bluetooth: to help capture patient vital signs

security: integrated fingerprint reader, hardware based encryption

Then on to smart pumps like Hospira’s Symbiq which delivers precise amounts of fluids, medications, blood, and blood products.

More safety checks – this time between the patient code, the IV bag bar code and the pump bar code. A wireless link connects both the pump and the bar-code scanner to the main database, which matches patient, order, and pump. If correct, the order is checked against the hospital drug library that contains formulation and dosing guidelines. Once verified, the pump is automatically programmed and the infusion can begin.

For pills, there are other smart dispensers such as this Medicine Cabinet developed by Accenture.

At the show we also saw various voice recognition products from Nuance. Doctors are notoriously poor scribblers so dictating prescriptions can also reduce other medication errors.

Of course, as with accounts payable, you can also have a 4 way match by introducing cross-check with an inspection report. My wife who works part-time at a hospital tells me about the four-way match in health care: The patient who asks “how come my pill today is pink. It was blue yesterday”. Inspection report indeed.