Barcode Scanning Behind Pharma’s Zero-Miss Safety Inspector.

How Do You Improve Patient Safety? Zero-Miss Barcode Reading and Automation.

One of the most critical goals in healthcare is patient safety, which includes anything from the transfer of information to administering the right medication. With so many factors contributing to the daily battle, it is comforting to know that ZiuZ Medical has placed the identification and validation of automatically dispensed medication firmly in the "certified and mastered" column worldwide.

automated pill inspection via barcode scanner
Figure 1: ZiuZ Photon Photon line of medication dispensing checking devices for bigger medication pouches production sites.

ZiuZ Medical, a global visual intelligence company based in The Netherlands, set out to help pharmacies using automatic dose dispensing systems to assemble and package patient medications accurately without fail. Once a pill leaves a bottle and moves from one caregiver to the next, that pill loses its identity, and it’s often difficult to remember exactly what it is—especially when many drugs can look so similar. Automatic dose dispensing came to the rescue with the ability to individually package medications together so that only the medicines intended for a specific patient are, in fact delivered to that patient. But what happens if during that automation process, the wrong pills get placed into the package? Using 13 parameters, near-infrared (NIR) image analysis technologies, and intelligent algorithms, ZiuZ can identify each pill or capsule within each bag during this automation process at a rate of six inches per second. Each medication pack then receives approval or rejection, ensuring only the correct medication is ever placed in each bag.

Getting a Grip on Quality

As you can probably imagine, one of the most crucial elements to get right for patient safety would be dispensing the right drugs each and every time—no matter the workflow. Each patient’s needs are unique, making the treatment process varied and often complicated. Ensuring that each patient gets the proper dosage of the correct drug is vital, and errors can be fatal.

A study titled, "Medication errors: the importance of safe dispensing," published by the British Journal of Clinical Pharmacology states that the most common causes of dispensing errors were: being busy, being short-staffed, being subject to time constraints, fatigue of healthcare providers, interruptions during dispensing, and look-alike/sound-alike medicines (1). It is clear that automatic dose dispensing and dispensing machines have been recommended as one potential mechanism to improve efficiency and patient safety, and they are now widely used in many hospitals (2). There is no doubt that these machines can enhance the efficiency of medication distribution, but their capacity to reduce medication errors is controversial and depends on many factors. In answer to the quality control battle, ZiuZ Medical created an intelligent solution incorporating the industry’s best image-based barcode scanning software from Code Corporation. When a patient’s life can hinge on having a solution that automatically verifies the contents of each pill pack, ensuring that they contain the correct medication before there is a chance of it reaching the patient is a healthcare win from any perspective.

Testing, Testing, 1-2-3

The task was to find a way to identify each individual pill within every given medication pack assembled and find a way to compare that information with what should be located inside each package and identify errors. This process would need to include difficult medicines and capsules, and situations with broken pills or crumbs.

The ZiuZ intelligent system started with a detailed photograph of the transparent side of each bag to show the contents of the pouch, but it needed to reliably scan and decode the 2D barcode printed on the back of each pack containing the details of what items should be found inside. This part played a crucial role. Without it, their technology would not be able to perform the verification and comparison to deliver a "match or error" result. Finding an enterprise-grade, high-performing scanning solution that would scan without fail the 2D barcode on the printed side of this reflective bag proved a challenge, until they discovered Code’s CortexDecoder®.

In healthcare, as in a lot of industries, time is a valuable resource. However, unlike most businesses, time is more than money in healthcare because life and death decisions are made in seconds. The right scanning solution would make checking packs of medication fast and accurate while reinforcing a superior product reputation. ZiuZ turned to Code, integrating CortexDecoder into the med pack checking device. The result? CortexDecoder has delivered a scanning experience that exceeded all of ZiuZ Medical’s expectations.

Prior to CortexDecoder, ZiuZ used a decoder that had an error rate of .05%. This meant 1 in every 200 barcodes was misreading, and the potential for dispensing the wrong medication could be catastrophic. This was clearly unacceptable to ZiuZ, and it led to the search for a decoding algorithm that would be able to meet the critical demands of the company. The decoding software that ZiuZ sought had to deliver on three essential things:

(1) The error read rate needed to be as close to zero as possible.

(2) It needed to be able to read 2D barcodes moving at a speed of approximately six inches per second.

(3) It had to flawlessly decode from the reflective surface of the shiny, thin foil packs that wrinkle easily and compromise the barcode readability.

Finding a barcode decoder algorithm to meet these exacting requirements seemed, at times, nearly impossible. ZiuZ tested a few decoding platforms, but each one came with an issue that impeded their ability to function at the standards they had set for their equipment. They knew the exacting specifications were challenging, but they also believed the solution had to exist. However, after additional platforms were investigated, doubts began arising. The benefits of their system and its ability to provide life-saving care to patients kept them searching, and ultimately they came upon Code. They were impressed with the power and versatility of CortexDecoder, and a simple test drive of the SDK was all it took to move ZiuZ forward.

Enterprise Barcode Scanning Software Solution: CortexDecoder

The performance of CortexDecoder exceeded every expectation. CortexDecoder scanned thousands of barcodes before even one could be identified as an error.

The 2D barcode printed on the back of the medication packets holds the information of which pills and how many are supposed to be in every pack. That information needs to match the photograph that the machine takes of the transparent side of the bag. These dispensing machines only have one chance to read each barcode that zooms by. CortexDecoder reads these barcodes with near zero-miss reliability, allowing verification to occur quickly and accurately. ZiuZ Medical found that, by integrating CortexDecoder, their machines were more efficient and helped ZiuZ move closer to improving patient safety worldwide.

"CortexDecoder provides the scan performance we have been looking for," says Johan van Duijne, Product Manager for ZiuZ Medical."Not only did the decoder perform better in our machines than we expected, but the customer support provided by Code made choosing their decoder even easier."

Decoding in Action
For OEM manufacturers looking to integrate enterprise-grade barcode scanning into their operations, there is a solution that will improve both efficiency and accuracy. CortexDecoder is a high-performance decoding algorithm that works on any platform or operating system and provides the results that will make you wonder why you didn’t make the move sooner.

By pairing CortexDecoder with the latest imaging technologies, you can deliver a market-leading product that will provide your customers with true enterprise-grade barcode scanning capabilities and near zero-miss performance in less-than-ideal scanning environments or on damaged barcodes.

Interested in learning more about our SDK features or test driving this tech for yourself? Contact us today 801-495-2200 or

Works Cited:

  1. Cheung, Ka-Chun, Marcel L Bouvy, and Peter A G M De Smet. "Medication Errors: The Importance of Safe Dispensing." British Journal of Clinical Pharmacology 67.6 (2009): 676—680. PMC. Web. 12 July 2018.
  2. Guidance on the interdisciplinary safe use of automated dispensing cabinetsHorsham (PA)Institute for Safe Medication Practices; 2008[cited 2009 Sep 8]. Available from:

Works Cited

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