While it has long since been demonstrated and accepted that bar coding medications improves patient safety and leads to more efficient distribution and accounting practices, often the underlying components of such a system are overlooked. While printers are one of the most basic elements of any bar code operation, they are critical to the success of these systems. Therefore, it is wise to invest the necessary time and energy into choosing the right bar code printer for your pharmacy operation.

Bar Code Printer Types
While the size, capabilities, and configurations of printers vary, there are two basic types of bar code printers to choose from—on-demand and batch-oriented. On-demand printers produce one or more labels as needed. They use labels that come on rolls, making it convenient to print just one label or a hundred. This type of printer comes in a wide variety of models, and labels are available in a range of sizes, colors, and application types from multiple vendors. Among the limitations of on-demand printers is that stocking and changing labels (and ribbon) to produce different sizes and types of labels can take up valuable time. 

Batch-oriented printers print to label or document sheets that often contain prefilled information. This is the best option for producing documents with bar codes as well as sheets of bar code labels for applications such as repackaging. Sheets of labels are available in a wide range of sizes and types, and document templates can be easily designed and altered as needed. However, these printers generally are not suited for one-off, single label printing. Individual sheets can be reused (with appropriate layout software), but often result in crimping that can jam the printer and damage the bar codes or other information on the document or label.

Selection Criteria
The main considerations for selecting a pharmacy printer include work process, workload (job speed), label requirements, and printer capabilities. Determining a printer’s supported bar code symbologies is an additional consideration.

Work Process
Detailing the process for which a bar code label is required will help you determine whether an on-demand or batch printer is the better choice. Are you labeling individual doses for dispensing or are you repackaging? Mixed process pharmacies may find that two printers, one optimized for each process, is a better choice than a single printer forced to do both jobs, particularly if a rush on-demand job comes in the middle of a batch job.

Workload
The speed of the printer is a critical factor during peak workloads. While a printer may be rated at a certain number of labels per hour, you should look at how it handles batch and on-demand labels. Batch labels will usually print more quickly because there is no additional processing time required to change text or bar codes. On-demand printers may slow down between labels if the data is dynamic, as is often the case with patient IDs. Remember that speed is usually an optimal measure and not necessarily a realistic predictor of performance. Less expensive thermal and thermal transfer printers may experience print-head heat build-up if run at capacity for an extended period, which can lead to low grade or unreadable symbols.

Label Requirements
The placement of bar codes and other necessary information varies greatly depending on the items being labeled. Individual vials, bags, or samples typically require a small label with tightly organized information, whereas repackaging typically involves producing a larger label. Labels that might be subjected to solvents or other chemical spills require special materials to ensure the bar code remains readable. In all cases, it is important to ensure that appropriate supplies are readily available. This may seem obvious, but certain sizes or materials may not always be available or may not be available for all models of printers. When testing potential machines, determine how easy the stock is to handle, load, and remove. The form of label stock also is a consideration if you frequently need to print different sized labels—sheets can be quickly changed, but changing paper or label rolls is more time consuming.

Capabilities
Printers that can store commonly used formats and have resident bar codes allow printing from spreadsheets, databases, and other information sources generally not intended for label production. This functionality can reduce processing time when printing variable data such as individual patient doses and IDs. Printer interfaces (eg, RS-232, LAN, USB) should be reviewed but are usually not an issue.

Bar Code Symbologies
The type and number of supported bar code symbologies can also play a role in printer selection. Many pharmaceuticals are, or will be, using GS1 DataMatrix and one or more format of GS1 DataBar (formerly RSS or Reduced Space Symbology). While you may not need these symbologies presently, it is likely they will become more common in the near future for use on very small labels to encode lot/batch and expiry in a small symbol.

Conclusion
The most obvious prerequisite for a pharmacy printer is that it meets your work requirements. What is less obvious is that employing more than one type of printer may be the optimal solution for your needs. The cost of two printers may in fact be little more or even about the same as a single, heavy-duty machine tasked with dissimilar requirements. Also, keep in mind that a secondary printer could temporarily handle the entire workload should the other printer fail. As with any hospital pharmacy operation, having a reliable back-up plan is always a good idea.

Bert Moore is the director of IDAT Consulting & Education, a vendor-and technology-independent consulting firm helping companies understand and evaluate automatic identification and data collection (AIDC) solutions.