Designing a Barcode Scanning System for Organization and Dispensation of Medication B.E.H.O.P.E. Biomedical Engineers Helping Optimize Pediatric Efficiency Vanderbilt University Jelisa Carter, B.E. Biomedical Engineering, December 2015 Ekom Eyoh, B.E. Biomedical Engineering, B.A. Neuroscience, May 2016 Miranda Kunz, B.E. Biomedical Engineering, May 2015 Siji Oluwadara, B.E. Biomedical Engineering, May 2015 Technology and Value Proposition Our technology is an automated system that will decrease the incidence of dispensing error by reducing the chance for human error during the dispensing phase of medication allocation in a hospital’s pharmacy. Similar systems have been used in commercial pharmacies such as CVS and Walgreens, proving that our technology is technically feasible. The key principle in the design and development of this project is bioinformatics, specifically barcode scanning. Barcode scanning systems, such as QR codes, are popular today with the advancement of mobile phones. These systems have demonstrated proof of key principles. We will use this technology to address error rate during the dispensing phase of medication allocation for our customers, hospital pharmacies. The current standard process in these pharmacies requires that the pharmacy technician read and sort prescriptions, select the drug, and administer the dosage. The pharmacist then double checks that the correct dosage has been administered. However, this process is susceptible to human error and misidentification of drugs. In a seven-month long study that consisted of the observation of 140,755 medication doses filled by a pharmacy, it was found that 3.6% (5075) contained errors. Only 79% of these errors were identified by the hospital pharmacist during routine verification. Of the undetected errors, 23.5% were potential adverse drug events (ADEs), of which 28% were serious and 0.8% were life threatening. The most common potential ADEs were incorrect medications (36%), incorrect strength (35%), and incorrect dosage form (21%). [2] To reduce the frequency these human errors, automated systems have been implemented in some pharmacies. After conducting a “prior art search,” [1] we found that we have the freedom to operate because of the design features that distinguish our technology from other present technologies. Distinguishing design features of our device will streamline the medical dispensing and allocation process at hospital pharmacies. Our technology will be creatively constructed so that it can be manipulated to fulfill the specific needs of our customers. For example, our technology would be available for use as both a handheld device and a mobile application for low resource hospital settings. We believe our technology is better than other solutions on the market because it will be programmed to fulfill the unique needs of hospital pharmacies, including catering to complex floor plans and workflows, as opposed to commercial pharmacies. The mobile app portion of the project will also serve to demonstrate proof of concept. The mobile app will have all the software capability of a barcode scanner and will be able to check whether the correct medication is being dispensed. When it is demonstrated that the barcode scanner does indeed increase the accuracy and efficiency of the dispensing process, then the goal will be to translate the software to a hand-held device that can be linked internally to the hospital’s computer system without having to store patient data on the cloud. Successful adoption of our barcode scanning device would reduce the error involved in dispensing medication at the pharmacy. If fewer errors are made, the result is lives saved. The right medication goes to the right patient, thus avoiding potentially harmful dosage administration or administering the wrong medication altogether. Our device would also reduced stress in the pharmacy environment by increasing the certainty with which medication is being dispensed. If pharmacists don’t have to repeatedly, manually check whether the proper medication is being dispensed, the dispensation process should be streamlined. Business Model and Market The goal of our product is to cater to the need of hospital pharmacies. Currently, in some hospital pharmacies, there is no barcode scanning system and all of the medication organization is done by hand. There are also hospital pharmacies that have a barcode scanning system, but are in need of an overall better system. This can cause many organizational and informational human errors. By using a more structured barcode scanning system, the hospital pharmacies would experience less error and would increase efficiency of medication organization and distribution. Also, this system would reduce risk of death caused by drug related errors and ultimately, eliminate the possibility of a lawsuit against the hospital. The current market for our product is somewhat small considering that we have only been approached by one hospital in need of said barcode scanning system. However, to increase the market size, we could search outside of Nashville and possibly outside of the state for need of a barcode scanning system in a hospital pharmacy. We are proposing a system that would organize the medical information as well as verify the information for a given drug with the records of the Center for Disease Control. In comparison to competition, our product would create less errors because of the double checking mechanism of the proposed program. We would also be creating portable scanning devices that would be efficient for scanning multiple barcodes in different locations simultaneously. The other competition is the McKesson robotic dispensing system that many other facilities use. This system, however, is rather large and is not conducive to all floor plans and workflows. We therefore plan to introduce an alternative barcode scanning system that will offer the same accuracy of dispensing with more flexibility. To commercialize our barcode scanning product, we will license out our patent so that other companies can manufacture the hardware components, including the circuitry and the casing of the handheld device. As a BEHOPE team, we will then market our customizable hospital pharmacy barcode scanning system hospital to hospital. We will initially focus our marketing on hospitals that do not currently implement barcode technology in their medication dispensing processes. Later, we will begin to market to hospitals who currently have a scanning system but could benefit from the added features of our system. We will also handle sales and arrange distribution in house. In order to control all marketing, sales, and distributing of our product, we envision a forprofit venture. Although we share intellectual property rights and therefore profits with Vanderbilt University, the BEHOPE team can still be considered inventors on any patents on this design. The patent can be licensed to manufacturers to produce the handheld devices, and then the integrated systems will be sold to our customers at hospitals. This sale would include an end user license agreement so that the hospitals would be licensed to use our software. Considering our product involves mostly software design, such as app development and barcode technology, it should be very economically sustainable.The development of a handheld device will incur a cost for hardware materials. For the handheld device, we intend to store barcode data on hospital servers to reduce cost and increase data storage efficiency, considering hospitals already have data on all of their patient prescriptions on their servers. The costs of materials needed to develop our first prototype of a handheld device are estimated in the Table 1. Based on these costs, we plan to be able to sell handheld devices for $250 initially. In the future, we may offer software updates and upgraded handheld devices for hospitals at an additional cost in order to sustain our profits. Material Estimated Cost Arduino $40 Casing $100 Circuitry $10 Table 1. Estimated costs of materials for first handheld device prototype. Team Members The BEHOPE team consists of four biomedical engineering students in their senior year at Vanderbilt University: Jelisa Carter, Ekom Eyoh, Miranda Kunz, and Siji Oluwadara. With her dedicated practice in programming, Jelisa will assist with software development. Using her knowledge of web page building, she will also maintain the webpage for the group . As an engineering management minor, Miranda will provide the business development expertise for the group. She will also use knowledge gained from her other minor, psychology, to give insight into the human factors concerns of our design process. Ekom will be assisting with programming the software for the product and managing the flow of the team. Also, she will be the liaison between the team members, mentors, and other parties. As a member who has a minor in the arts, Siji will provide insight into the creativity product development. Siji is a radical and adaptive innovator that will assist in seeking creative solutions but also guide the team to implementation by establishing weekly objectives. The team will be advised and mentored by Dr. Matthew Walker, Associate Professor of Biomedical Engineering at Vanderbilt University. They will also be mentored by their project sponsor, Dr. Amy Potts, Assistant Director of the Department of Pharmacy at Monroe Carell Jr. Children’s Hospital at Vanderbilt University. Work Plan and Outcomes For this product to be successful, there should be a working prototype installed in the first hospital (Monroe Carell Jr. Children’s Hospital) by the end of the academic year. The new system utilizing the prototype should have a lower dispensing error rate than the current, completely manual system. In order to meet this goal, the following timeline of tasks has been established (note: some tasks may begin before the previous task is completed): Completion Date Task Description 11/7/14 Collect data Observe current system in hospital and alternate system in a commercial pharmacy, ascertain current system costs, and survey users about concerns with the current system 11/10/14 Evaluate Data Identify what improvements to the current system may be made 11/10/14 Generate Design Criteria Develop approaches to improvements 11/13/14 Evaluate Design Criteria Select approaches to focus design on 1/5/15 Gain Domain Knowledge Gain a comprehensive understanding of barcoding, mobile app development, CDC language, and hospital medication coding 2/2/15 Develop Mobile App Prototype Develop the first iteration of a barcode scanning system using a mobile platform 2/9/15 Test and Modify Mobile App Prototype 2/23/15 Program Arduino Use Arduino to program handheld scanning device 2/23/15 Manufacture Handheld Device Prototype Create casing for Arduino 3/9/15 Integrate System Integrate the Arduino, handheld device casing, and the hospital computer system 4/6/15 Test and Modify Integrated System 4/20/15 Communicate Process 4/20/15 Marketing and Sales Present design process and features to peers, faculty, and investors Appendices I. Patents that are related to barcode scanning devices for pharmaceutical purposes A. http://patft.uspto.gov/netacgi/nphParser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearchadv.htm&r=54&f=G&l=50&d=PTXT&s1=%22Barcode+Scanner%22&s2=Pharmaceutic al&co1=AND&p=2&OS=%22Barcode+Scanner%22+AND+Pharmaceutical&RS=%22B arcode+Scanner%22+AND+Pharmaceutical B. http://patft.uspto.gov/netacgi/nphParser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearchadv.htm&r=16&f=G&l=50&d=PTXT&p=1&S1=%28%28verification+AND+medicatio n%29+AND+barcode%29&OS=verification+AND+medication+AND+barcode&RS=%2 8%28verification+AND+medication%29+AND+barcode%29 C. http://patft.uspto.gov/netacgi/nphParser?Sect1=PTO2&Sect2=HITOFF&p=1&u=%2Fnetahtml%2FPTO%2Fsearchbool.html&r=2&f=G&l=50&co1=AND&d=PTXT&s1=%22Barcode+Scanner%22&s2= medication&OS=%22Barcode+Scanner%22+AND+medication&RS=%22Barcode+Scan ner%22+AND+medication II. Cina JL, Gandhi TK, Churchill W, et al. How many hospital pharmacy medication dispensing errors go undetected?. Jt Comm J Qual Patient Saf. 2006;32(2):73-80. Jelisa E. Carter 4623 Rolling Brook Ct Union City, GA 30291 678.742.4752 jelisa.e.carter@vanderbilt.edu 2301 Vanderbilt Pl, PMB 354043 Nashville, TN 37235 Objective An internship or co-op in the field of Biomedical Engineering. Education Vanderbilt University – Nashville Bachelor of Engineering in Biomedical Engineering, Fall 2015 Class Level: Senior Relevant Coursework: Biomechanics, Biomaterials, Systems Physiology, Circuits, Bioinstrumentation, Neuromuscular Mechanics and Physiology Technical Projects, Labs, and Research Construction of a Infrared Thermometer Infrared thermometer was constructed using Arduino chip, programming, and infrared temperature detector. Research on MRI detection of brain activity (paper in progress) Research using MRI scans of different brain images coated in different proteins to show particle movement through axons. Leadership Beta Nu Theta Social Organization, Creekside High School, Vice President [2008-2011] Creekside High School Marching Band, Section Leader [2007-2011] Tau Beta Sigma National Honorary Music Sorority, Vice President of Membership [2013-2014] National Instruments Leadership Symposium, Vanderbilt University, Spring 2014 Vanderbilt University, Spirit of Gold Marching Band, Co-Section Leader [2014-2015] Technical Skills Computer: LabView, Matlab, Microsoft Office, C++ programming, Java Equipment: machinery, robotics Involvement / Community Service Biomedical Engineering Society, Vanderbilt University Chapter National Society of Black Engineers Vanderbilt University Spirit of Gold Marching Band Volunteer at local Petsmart (2013-2014) Interests: Music, dance, crossfitting Work Experience Memorial Healthcare System – Pembroke Pines, FL Biomedical Engineering Intern Responsible for inventory of medical machines throughout the hospital Repair of malfunctioning medical equipment; knowledge of machines and circuitry Team oriented problem solving Troubleshooting and assessment of clinical devices Vanderbilt Imaging Institute – Nashville, TN Undergraduate Research Assistant Brain imaging to assess particle movement through the axons in the brain. Image registration, masking, and cropping using Matlab and photoshop Team oriented problem solving Troubleshooting and assessment of a large number of multiple images Current Address Address Ekomobong E. Eyoh ekom.eyoh@vandberbilt.edu Summer 2014 – Present Fall 2014 - 2011 Permanent 2301 Vanderbilt Place Rd Nashville, TN 37235 TN 37013 (615) 916-9637 7132 Smokey Hill Antioch, (615) 941-2853 EDUCATION Vanderbilt University Nashville, TN May 2016 Bachelor of Engineering, Biomedical Engineering Bachelor of Arts, Neuroscience EXPERIENCE Systems Biology and Bioengineering Undergraduate Research Experience, Nashville, TN Undergraduate Research Assistant (Spring 2013 to Spring 2014 including summer) · Developed a research project · Collaborated with advisors at Meharry Medical College and Vanderbilt University · Learn the theory, use, and analysis of mass spectrometry · Developed cell culture techniques distinct to the cell types being experimented on · Analyzed comparisons between the mass spectrometry data using MassLynx, XCMS, and R MEDLIFE Spring Break Trip – Peru Spring 2014 · Shadowed general practitioners, an OB/GYN, and a dentist · Worked with other students on a community development project that benefitted two communities in poor Peruvian neighborhoods · Worked to educate community members on proper hygiene and general preventive medicine · Assisted dentist in filling teeth and OB/GYN with mammograms and pap smears LEADERSHIP Christians United for Israel Vice President, Treasurer, and Secretary (2012-2014) · Facilitated the bringing of speakers to campus · Organized a community and campus integrated event called Night to Honor Israel · Formed relationships between people of different faiths to work for causes that they had in common · Handled the finances and reimbursements associated with group expenditures Every Nation Campus Ministries Worship Leader (2014-2015, 2012-2013), Leadership Board Member (2013-2014), and Treasurer (2012-2013) · Organized band practices and selected songs for each week · Coordinated with other Christian groups and local church for worship-based events · Reviewed yearly revenues and expenditures and projected budget for the following year · Helped organize large outreach events (International Thanksgiving Dinner, God’s Not Dead Week) MEDLIFE Co-fundraising/Events Officer and Treasurer (2014-2015), Co-fundraising/Treasurer Officer (2013-2014) · Talked with local business about making donations and giving support for fundraisers · Helped plan and facilitate small and large fundraisers · Collected dues, organized the yearly budget, and formulated projected budget for the following year · lead and utilized committee members to divide up work load amongst the members Miranda Kunz Current Address: PMB 352393 2301 Vanderbilt Place 55112 Nashville, TN 37235-2393 Phone: 763-807-8531 E-mail: miranda.s.kunz@vanderbilt.edu Permanent Address: 8284 Pleasant View Dr. Mounds View, MN EDUCATION Bachelor of Engineering, Biomedical Engineering, Degree anticipated May 2015 Vanderbilt University, Nashville, Tennessee Minors: Engineering Management, Psychology GPA: 3.612/4.0 Irondale High School, New Brighton, Minnesota GPA: 4.0/4.0 unweighted EXPERIENCE Vanderbilt Optical Imaging Laboratory, Nashville, TN Undergraduate Researcher (May 2013-present) · Cultured breast cancer cells · Imaged cells using multi-photon microscopy · Analyzed and communicated data Luther Park Camping and Retreat Center, Danbury, WI Day Camp Director/Assistant Program Director (June 2014-August 2014) · Worked as part of leadership team to plan daily activities and oversee staff · Communicated with partner churches to plan and coordinate Vacation Bible Schools each week Camp Counselor (June 2012-August 2012) · Led games, Bible studies, arts and crafts, worship services, and devotionals for groups of 4-30 campers, ages 4-16 ACTIVITIES Vanderbilt Every Nation Campus Ministries (2011-present) Vice President (2014-present) Secretary/Treasurer (2013-2014) Engineering World Health, Vanderbilt Chapter (2011-present) Vice President, Internal (2014-Present) Treasurer (2013-2014) Vanderbilt MEDLIFE (2014-present) Co-Fundraising Chair (2014-present) Vanderbilt Student Volunteers for Science (2011- 2012) ACHIEVEMENTS National Merit Scholar, 2011 Girl Scout Silver Award, 2008 SKILLS Experience with Matlab, Mathematica, and Microsoft Office Suite.