Informatics, digital & computational pathology

Laboratory information systems

Barcoding and tracking

Last author update: 7 March 2022
Last staff update: 7 March 2022

Copyright: 2021-2023,, Inc.

PubMed Search: Laboratory information system barcoding tracking

Syeda F. Absar, M.D., M.P.H.
Jeffrey W. Prichard, D.O.
Page views in 2022: 487
Page views in 2023 to date: 277
Cite this page: Absar SF, Prichard JW. Barcoding and tracking. website. Accessed May 30th, 2023.
Definition / general
  • Barcoding and tracking systems allow surgical pathology practices to be supported by computer readable information
  • To achieve maximal laboratory efficiency, they standardize and automate work processes by encoding identification of specimen parts at accession, grossing, histology and pathology sign out areas
  • Scanning ensures patient safety by reducing laboratory errors, increasing efficiency and allowing for quality management
  • Main technologies involve barcode and radio frequency identification (RFID)
Essential features
  • 2 main technologies for scanning and tracking in surgical pathology are barcode and radio frequency identification
  • These allow for surgical pathology practices to be supported by computer readable information for laboratories to be efficient, standardized and automated
  • Barcodes exist as linear 1 dimensional barcode lines and matrix 2 dimensional barcode dot matrices
  • RFID tags can be passive (no internal power source) or active (battery powered)
  • 1D barcode = linear code
  • 2D barcode = data matrix code = QR code
  • Radio frequency identification (RFID)
  • Laboratory information system (LIS) / laboratory management system (LMS)
  • Quality assurance (QA) / quality control (QC)
Barcode and RFID technologies
  • Barcodes (Am J Clin Pathol 2009;131:468, Surg Pathol Clin 2015;8:123)
    • More accurately read information from small labels than human eye for fewer identification errors
    • Can employ quality controls of checksums or check digits and internal control lines to ensure barcode is intact and read correctly or scan fails
    • Can scan multiple slide and block labels at a time
    • Linear 1D barcode lines: limited information in larger space
    • Matrix 2D barcode dot matrix: more information in smaller space



      Data matrix

  • Hardware
    • Scanners
      • Each barcode reader is connected to an individual computer at
        • Accessioning
        • Grossing stations
        • Tissue processors
        • Microtomy
        • Staining
        • Slide assembly
        • Slide distribution
        • Pathologist workstations
      • Requires adequate computers and network bandwidth to support laboratory operations
      • Includes
        • Contact wands
        • Laser barcode scanners
        • Image based (camera) barcode readers
      • Can be wired, wireless or fixed / mounted
      • Are preferably omnidirectional, as they read symbologies in any orientation
    • Printers are essential for labeling specimen containers, cassettes and slides
      • Labels include barcodes and other patient identification information (case accession number, patient name, slide number, etc.)
      • Print on an adhesive label or directly onto the cassette or slide
      • Printing technology includes impact (dot matrix) and nonimpact (ink jet, laser and thermal) printing
  • Implementation involves
    • Planning for which specimens need tracking and what the data will be used for
    • Selecting appropriate label
    • Determining the space available for hardware
    • Developing a plan for IT downtime
    • Assessing degree of IT support and finances
    • Choosing a vendor whose software maintains interoperability with the laboratory's existing LIS, instruments and computers
  • RFID (atlasRFIDstore: Active RFID vs. Passive RFID - What's the Difference? [Accessed 29 June 2021])
    • Passive RFID
      • Uses tags with no internal power source; instead, these tags are energized by the electromagnetic energy transmitted from an RFID reader
      • Used for applications such as access control, specimen tracking, supply chain management and more
      • Has lower price point per tag than active RFID tags
    • Active RFID
      • Uses battery powered RFID tags that broadcast their own signal
      • Commonly used as beacons to accurately track the real time location of assets
      • Provide much longer read range than passive tags
        Roll of passive RFID tags

        Roll of passive RFID tags

        Example of active RFID tag

        Example of active RFID tag

        Comparison between passive and active RFID tags

        Passive versus active RFID tags

Barcode and RFID scanning data applications in surgical pathology
  • Barcode or RFID on badges facilitates identification and login of staff to access rooms, equipment and software
  • Barcoded paper requisitions can be scanned to file into document imaging systems
  • During case accessioning, scanned requisitions and containers are positively identified and matched to the correct patients in the LIS
  • Verification of relationship of requisitions to specimens, blocks and slides
    • For accurate and safe handling and transfer between workflow steps
    • To prevent mislabeled components and tissues
  • Scanning requisitions or specimen containers at grossing bench can trigger tissue cassette engraver labeling on demand
    • Only blocks labeled for the specimen being grossed are available
      Barcoded examples

      Barcoded examples

  • Scanning cassettes into tissue processing racks records
    • Date and time a workflow step occurs
    • Grossing staff
    • Grossing station location
    • Time that the fresh specimen tissue was placed in formalin
  • Grouping cassettes in the racks for tracking through tissue processing
  • Tissue processors and racks can be barcoded to
    • Identify groups of blocks
    • Specify which processor and which protocol is associated with each tissue block
    • Determine appropriate handling of tissue for ancillary tests with special requirements
  • Barcoding at embedding can
    • Display gross description of tissue count, color and sizes
    • Display gross images
    • Track work unit processing
  • Verify completeness of sets of slides for each case at case assembly before delivery to pathologists
  • Record metrics of units worked when requisitions, specimens, blocks and slides are scanned at specific workstations under specific staff logins
  • Monitor and trend time between work steps (takt time in Lean language)
    Barcode data to visualize workflow Barcode data to visualize workflow

    Barcode data to visualize workflow in histology

  • Tablets or wall mounted monitors can facilitate visual presentation of work being done in any work area
    • As graphs of barcode or RFID scans
      • Visible to all staff
      • Available during walkthrough by management
      • Remotely accessible
  • Track location for storage, retrieval and purging of specimens, blocks and slides
  • Automate identification of slides for
    • Assignment to pathologist
    • Whole slide imaging and analysis
  • Scanning a tag to open a case rather than manually typing can assure synchrony between the scanned object and the LIS context
  • Reference: Clin Lab Med 2008;28:207
PotentialĀ barriers and limitations
  • Cost consideration for low volume practices
    • Implementation requirements include workflow process development and modification, training, education and testing
    • IT expertise for initial implementation and support
  • Interoperability of the instrumentation within the AP laboratory and with the other laboratories in the same institution
  • Operator error, for example, tissue mixup during grossing or embedding or slide labeling error
  • Mechanical delays from poor quality label printing and label printer maintenance issues
  • References: Clin Biochem 2012;45:988, Diagnostics (Basel) 2021;11:2167
Board review style question #1

What is the name of this barcode?

  1. Active RFID tag
  2. Linear 1D barcode lines
  3. Matrix 2D barcode dot matrix
  4. Passive RFID tag
Board review style answer #1
C. Matrix 2D barcode dot matrix

Comment Here

Reference: Barcoding and tracking
Board review style question #2

Which of the following is true about the use of RFID scanning in surgical pathology?

  1. Passive RFID tags are commonly used as beacons to accurately track the real time location of assets
  2. Passive RFID tags are more expensive than active ones
  3. Passive RFID tags are used for applications such as access control, specimen tracking and supply chain management
  4. Passive RFID tags use battery powered RFID tags that broadcast their own signal
Board review style answer #2
C. Passive RFID tags are used for applications such as access control, specimen tracking and supply chain management

Comment Here

Reference: Barcoding and tracking
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