KEY POINTS:
The Health Ministry wants hospitals to spend more than $100 million on computer systems and bedside barcoding of patients to reduce fatal and disabling drug errors.
A discussion document obtained by the Herald under the Official Information Act shows the scheme would cost up to $114 million over 12 years.
The proposal is for all public hospitals to introduce fully electronic drug-prescribing systems or computerised patient medication records and connect these to the hospital pharmacy. Drugs would be re-packaged into single-dose packs carrying barcodes, and patients would wear bracelets containing their own unique barcode.
Nurses would scan the drug pack and bracelet before giving patients their medicines, and errors - such as the wrong patient or wrong drug - would be flagged.
"The gross cost of the project will be offset firstly by a potential saving of about 1050 lives [over the 12 years]," says the report by Bruce Anderson, the ministry's manager of governance for district health board funding and performance.
It would also save around 2800 people from suffering permanent disabilities, 29,000 from shorter-term disabilities, and hospital stays would be reduced.
"While these benefits are difficult to quantify in financial terms, patients and their families affected by adverse events would likely agree that the benefits are immeasurable."
On average, patients who suffer a medication error spend an extra 7.5 days in hospital, in addition to the time spent treating their original ailment or injury. Avoiding these extra hospital stays would save around $115 million over the 12 years, offsetting the expenditure.
The Quality Improvement Committee - which advises Health Minister Pete Hodgson and is headed by Counties Manukau District Health Board chairman Pat Snedden - has supported barcoding.
Dr Anderson said that in the US, point-of-care barcoding and associated systems had reduced adverse drug "events" by 65 to 86 per cent.
Doctors' drug prescriptions in New Zealand hospitals were still commonly hand-written.
Studies had shown that 39 per cent of drug errors occurred in prescribing, 12 per cent in transcribing, 11 per cent in dispensing and 38 per cent in the giving of drugs.
In this year's Budget Mr Hodgson provided $10.2 million over four years for the barcoding scheme.
He announced the money in May before the Budget and following an investigation into the death of Mervin McAlpine after a medication mix-up at Auckland City Hospital in 2004.
The 82-year-old diabetic was given the wrong drugs after the hospital mixed a fax from his GP with the records of another patient. The error hastened his death.
Dr Anderson said capital expense on barcoding would be about $44 million (including machines to repackage drugs), and it would cost about $10 million to implement and $3.5 million to $5 million a year to run.
THE HUMAN COST
* In New Zealand an estimated 5000 people a year suffer medication errors in hospitals.
* About 150 of them die from the errors.
* More than 400 are left with permanent disabilities.
* About 4000 suffer short-term disabilities.
* Bedside barcoding in the US reduced adverse drug events by 65-86 per cent.
