Editor's Note: Mark Nuenschwander is regarded as one of the experts in hospital automation and point-of-care technology, in the US.
Australia is about to go down this pathway in the hope that many of the seemingly intractable healthcare problems will untangle and deliver Australians a quality healthcare system that taxpayers, in reality, are paying too much for.
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I’ve been thinking about Old Glory, Cuba, RFID chips, and bar codes entering the third dimension.
Whether you voted for John McCain or Barack Obama, I think you have to admit we are blessed in these United States. Our ballots had two pretty good options and neither was Castro. I just couldn’t talk about bar codes without first waving the flag, which, by the way, hasn’t changed much since Betsy’s iteration.
I remember the last two alterations. Do you? Alaska's star was sewn to the red, white, and blue on July 4, 1959—a few months after Castro took over Cuba. Hawaii’s was added one year later, and nothing has been changed since.
Likewise, bar codes haven’t changed much since their inception. The bars and stripes on the compact fluorescent lamps I purchased last night at Home Depot in Bellevue, are essentially the same as the first bar code scanned on that pack of Wrigley's Juicy Fruit at Marsh’s Supermarket in Troy, Ohio, in 1974. Actually, they are just like the UPC codes on cans of soda in downtown Havana.
I know the pundits are predicting that RFID is about to topple the bar code, but I think this is a premature assumption. Admittedly, we keep finding radio-frequency (RF) chips tucked into the packaging of pricy retail items. But their function has to do with theft protection, not data collection.
A Home Depot manager explained to me how hidden mechanisms beneath bagging areas of self-checkout stands automatically deactivate these RF tags after sales are completed. Well, most of the time. The shopper in front of me did everything right, and yet, when he left the store, his merchandise set off lights and sirens.
For all the jibber jabber about RFID tags displacing bar codes at points of sale, we haven’t seen much action. Data-filled radio chips will augment bar codes, but I believe it will take many years (if ever) before the little zebras are exiled.
Moving down the highway from the hardware store to the hospital, what can we expect at points of care? However long it takes for readable RFID chips to appear on paint cans, I suggest it will take again as long before they appear on packages of pills. Furthermore, I doubt that we will ever be leaning exclusively on microchips for capturing medication-administration data.
Meanwhile, without much fanfare, the bar code has been maturing. Linear symbols have quietly morphed into stacked renditions—allowing more data to be slipped into smaller spaces. The original version (one-dimensional) is deciphered by lasers reading the codes horizontally. The newer (two-dimensional) is deciphered by lasers reading the codes vertically and horizontally.
Month by month, we are running into even more data-rich symbologies (e.g., DataMatrix, Aztek, etc.) being applied to patient wristbands and some drug packaging. These complex 2-D bar codes, unable to be read by scanners, require imagers to decipher the data they carry.
However, I’m told we haven’t seen anything yet. Expect dramatic increases in a bar code’s data capacity before our world shifts allegiance to RFID chips.
If you are interested in tracking the bar code’s progress, I recommend Christopher Little’s Loftware Blogg. He’s convinced the bar code’s reign is secure: “Contrary to media predictions, the future of the bar code is not RFID tagged labels. The bar code of the future has orders of magnitude more capacity than any RFID and the same basic cost structure as today’s bar code.”
His conviction is rooted in recently invented 3-D bar codes, to which the third dimension of color has been introduced. The kitten of this new family is Microsoft’s patented, licensable four-colored bar code, which can carry 3,500 alphanumeric characters per square inch. That’s 3KB of data purring on your lap.
The king of the jungle is the PM Code, employing 256 colors for packing up to 2,854,408,421,376 characters per square inch. That’s 1.2 GB of data growling at you—enough to transport your mother’s longitudinal healthcare record and then some.
Fidel forever? Absolutely not. Stars and stripes forever? Certainly hope so. Bars and stripes forever? Probably not. Nevertheless, though it’s not politically correct to say so, I’m not expecting RFID to pull a coup in my lifetime.
What do you think?