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66 Section III. Implementation• Produce printed patient information on patient ID bands and patient ID labelsincluding the patient’s full name, medical record number, gender, account number,and date of birth.Subsequent phases of the project were envisioned to include medication and lab specimen/collectiontracking (phase II); equipment, personnel, and patient tracking; andmother/baby ID (phase III).Janet had been brought into the project early in 1999 and had worked hard to determinethe problems with the current system as well as a technology solution. The entireproject had been initiated not only in response to dissatisfaction with the current B-plate system but also because of an overall desire to eliminate errors in patient ID,medication administration, and specimen collection. Bar coding had been used in thelab for 15 years, and in the pharmacy for 5 years, so the technology base was familiarto end users. Janet felt there was no support in the medical center for keeping thecurrent B-plate system, so replacing it with more advanced technology seemed to bea good initial project for the QIC. The discussion today centered on phase I of the totalpatient ID initiative and whether a solution should be developed in-house or pursuedwith a third-party vendor. The MCC division was reluctant to support in-housedevelopment.The View from MCCThe quietly commanding voice of Carl Cusak, chief information officer, resonated frombehind his desktop, laptop, and personal digital assistant (PDA), all on active screens,as he summarized the reasons why he needed to call “time out” on the bar code projectand “regroup” to a prior point in the planning process. “Most projects involvingadvanced technology and informatics at University Hospital begin with fervor, energyand commitment, but often fail because pertinent points in process development areassumed or overlooked,” he noted. Carl spoke with the authority of his experience.The lack of MCC involvement meant that technical requirements had never beendefined, including details such as standards for data input, hardware infrastructurerequirements, or a charter document stating the purpose, scope, timeline, or productdevelopment requirements. In addition, software specifications and interface requirementswere lacking. Carl also felt that little attention was being paid to the substructureand interface problems inherent in bar coding, i.e., the capability of the bar codereader to read the code on a patient’s wrist band. The use of radiofrequency technologyand the use of hardware such as PDAs into which the bar code could be uploadedvia a software program, allowing real-time ID of patients and tracking, were considered,but the benefits and drawbacks were not well researched. Backup strategies forunanticipated breakdowns in the system also had not been defined.Carl complemented some of the long-standing individuals involved with the bar codeproject, such as Janet, for their commitment and effort. He noted that bar coding hadlong been used for applications in the pharmacy, the operating room, central supply,and the lab. Despite these varied uses of bar coding at University Hospital, however,no standards had evolved among these bar coding efforts. Carl admitted that MCCshould have taken ownership of these disparate bar coding projects earlier and shouldhave become the major shareholder in bar coding development. However, MCCpersonnel changes and priority mandates had kept it from assigning the necessaryresources to the project.