Barcode Tells the System. Colour Tells the Team: What Health Care Can Learn from Aviation
Airlines and hospitals may seem like very different environments, but they share a similar operational challenge:
How do we make sure the right subject gets to the right place, with the right information, at the right time?
In aviation, that subject may be a suitcase moving through check-in, loading, transfer and arrival.
In health care, it is a patient moving through registration, triage, diagnostics, medication administration, procedures, transport, discharge and follow-up.
Both industries rely on barcode technology. Both depend on scanning at different physical locations. Both need accurate digital records.
But both also understand something important:
The system cannot depend on the barcode alone.
Aviation still uses visible tags, colour-coded identifiers and human-readable information because not every situation is routine. Some bags are priority. Some bags are connecting to another flight. Some require special handling. Some miss a scan. Some are delayed, rerouted or damaged.
Health care is no different.
A patient identification wristband connects the patient to the digital record. A barcode can support positive identification for medication, specimens, diagnostics, procedures and movement through the hospital.
But some information needs to be visible before anyone scans.
A fall risk. An allergy. A special precaution. A safety consideration that the next person approaching the patient needs to see immediately.
That is why the comparison between luggage tags and patient wristbands is so useful.
The barcode tells the system who the subject is. The colour-coded alert tells the team what needs attention now.
Aviation designs for exceptions
One of the most important lessons from aviation is that the industry does not design only for the ideal workflow. It designs for exceptions.
Bags are delayed. Connections are tight. Tags are damaged. Scans are missed. Systems do not always behave perfectly.
Rather than treating every exception as a surprise, aviation builds structure around it. IATA Resolution 753 requires member airlines to track baggage at four key points: passenger handover to the airline, loading onto the aircraft, delivery to the transfer area and return to the passenger. IATA describes this as creating a verifiable audit trail for baggage acquisition and handover, and it also requires baggage tracking information to be shared with interline journey partners where needed. (IATA)
That is the aviation mindset: when something moves through a complex system, the handoffs matter.
Health care has the same challenge.
A patient moves from registration to triage, from emergency to imaging, from surgery to recovery, from one unit to another, from one shift to the next. At each handoff, information can be strengthened or lost.
The wristband becomes one of the most important physical links between the patient and the system.
But the wristband also has to work when the technology does not.
When the barcode does not read
This is a critical point.
When a health care barcode fails or cannot be read, the backup should not be informal improvisation. It should be a defined, required exception pathway.
The human-readable information on the wristband matters.
The care team should be able to read the patient’s name and date of birth, ask the patient to state their name and date of birth when they are able to do so, and compare that information against the order, medication, specimen label, chart, procedure request or electronic record.
This is not simply a backup.
It is also part of a second verification process.
A barcode confirms the patient to the system. The readable wristband and patient confirmation confirm the patient to the care team.
That distinction matters.
There is also a difference between asking a patient to confirm and asking a patient to identify themselves.
“Are you John Smith?” can invite a yes-or-no response.
“Can you please tell me your full name and date of birth?” requires active identification.
The Joint Commission’s 2026 Ambulatory Health Care National Patient Safety Goals state that organizations should use at least two ways to identify patients, giving the patient’s name and date of birth as examples, to make sure each patient receives the correct medicine and treatment. (Joint Commission Digital Assets)
When the patient can participate, the patient becomes part of the safety check. When the patient cannot participate, the organization needs a defined alternative: caregiver confirmation, two-staff verification, or another approved local process.
The key point is that a failed scan should not lower the standard of identification.
It should trigger a different controlled workflow.
So the question should not be, “Can we continue if the barcode does not scan?”
The better question is:
What is the controlled process when the barcode does not scan?
Is this really MFA?
This is where the language matters.
In consumer banking, government services and other critical apps, we have become familiar with MFA or 2FA. The principle is simple: do not rely on one signal when the risk is high.
In formal digital identity guidance, MFA means more than one distinct authentication factor. NIST describes MFA as requiring more than one distinct type of authentication factor for successful authentication, such as something you know, something you have or something you are. (NIST Pages)
Traditional bedside patient identification is not exactly the same thing.
A patient’s name and date of birth are not secret factors like a password. A printed wristband has not historically been a digital authenticator. A barcode and the printed name on the same wristband are not truly independent authentication factors.
So, in the clinical workflow, it is better to describe this as multi-layer identity assurance rather than classic app-based MFA.
That means using several reinforcing signals:
The machine-readable barcode. The human-readable wristband. The patient actively stating their name and date of birth. The visible alert band or label. The match against the medication, specimen, order, procedure or chart. The defined exception process when the scan fails.
The principle is the same as MFA, even if the mechanics are different:
Do not rely on one signal when the risk is high.
But the wristband is also evolving.
With mySPOT Onboarding, Medirex is redefining the hospital wristband as more than a passive identifier. Medirex describes mySPOT Onboarding as transforming hospital wristbands into secure digital keys. (Medirex) The wristband on the patient’s wrist as a “Secure Patient Identity Token” and references wristband-based authentication and a multi-factor identity model for patient portals, hospital kiosks, remote monitoring systems and government health care repositories. (Medirex)
That creates two related but distinct conversations.
At the bedside, the wristband supports clinical identity assurance.
In digital onboarding, the wristband can support authentication.
Those two workflows are connected, but they are not the same.
For clinical safety, the care team still needs a controlled identification process: scan the barcode, read the name and date of birth, ask the patient to state their name and date of birth when possible, and match the patient to the medication, specimen, order, procedure or chart.
For digital access, the wristband can become a secure token that helps the patient connect to the right digital record with less friction.
The strongest framing is not that health care should copy app-based MFA exactly.
It is that health care should adopt the discipline of multi-layer identity assurance.
This is a global issue
Patient identity, interoperability and traceability are not local hospital issues. They are global patient-safety issues.
In the United States, The Joint Commission continues to frame correct patient identification as a core patient-safety goal. (Joint Commission Digital Assets)
In Canada, Accreditation Canada states that its programs assess organizations against standards developed by Health Standards Organization, ISO and others, and that these standards are intended to support the highest achievable quality for patients. (Accreditation Canada) Accreditation Canada’s Qmentum Global program also describes a shift from Required Organizational Practices to Required Safety Practices, with the intent of creating a more direct impact on patient safety. (Accreditation Canada)
The global direction is clear:
Health care identity cannot be informal, local or improvised.
It must be standardized. It must be readable. It must be interoperable. It must be auditable. And when technology fails, the exception pathway must be controlled.
That is where aviation offers such a useful analogy.
Aviation does not only track the normal journey. It manages the exception.
Health care must do the same.
Aviation controls the exception. Health care often hands it to the team.
When baggage tracking fails in aviation, the exception is usually pulled back into a controlled system.
The bag still has a printed tag. The tag still has a number. The routing information is still visible. The bag can still be reconciled against a flight, passenger, transfer point or baggage file. The exception becomes part of the process.
In health care, the situation can feel different.
When the barcode does not scan, the initiative often shifts to the nurse, porter, technologist, pharmacist, physician or clinician standing in front of the patient.
That person still has to keep care moving.
The medication may be due. The specimen may need to be collected. The patient may be waiting. The scanner may be unavailable. The wristband may be damaged. The electronic system may be slow or down. The department may be under pressure.
At that moment, the safety system can become dependent on frontline judgment.
Frontline judgment is essential. But it should not be the entire safety net.
The safest systems do not ask people to invent a process under pressure. They give people a process to follow when pressure appears.
The hidden risk of non-system improvisation
When the barcode fails and there is no clear exception pathway, staff create their own.
That may be necessary in the moment. It may even be done with the best intentions. But it creates hidden variation.
One person asks the patient to state their name and date of birth.
Another reads the wristband silently
Another types a number manually
Another scans a spare wristband
Another documents later
Another skips the scan because urgent care is waiting
Each workaround may seem reasonable on its own. But across a hospital, those small differences create a second, informal system.
And informal systems are hard to audit, hard to train, hard to improve and hard to control.
This is where technology failure becomes workflow risk.
The risks include inconsistent patient identification, incomplete audit trails, delayed documentation, duplicate work, unclear accountability, workarounds that become normalized, and safety signals that never reach the people who can fix the system.
The technology failure is visible.
The workaround may be invisible.
Exceptions should become signals
Another lesson from aviation is that exceptions are not just operational problems. They are learning opportunities.
NASA’s Aviation Safety Reporting System collects voluntarily submitted aviation safety reports, acts on the information, identifies system deficiencies and issues alerts to people who are in a position to correct them. Its purpose is to collect, analyze and respond to reports in order to reduce the likelihood of aviation accidents. (ASRS)
Health care can apply the same thinking to patient identification.
A barcode that repeatedly will not scan should not be treated as a small annoyance
A damaged wristband should not simply be worked around
A missing alert label should not be accepted as normal
A department that regularly receives patients without readable wristbands should not be left to solve it informally
These are signals.
They may point to print quality, product selection, scanner reliability, workflow design, training, data placement, wristband durability, downtime procedures or handoff gaps.
If these failures are not captured, they remain invisible.
And if they remain invisible, they cannot be improved.
What health care can take from aviation
The lesson from aviation is not that health care should copy baggage handling.
The stakes are different. The environment is different. The subject is different.
But the system lesson is valuable.
Aviation tracks the routine journey, but it also controls the exception. It uses barcodes, visible tags, human-readable information, handoff points, escalation pathways and reporting systems.
Health care needs the same layered thinking.
A patient ID wristband should support barcode scanning
It should also remain readable by the care team
The patient’s name and date of birth should support second verification
Colour-coded alerts should make critical risks visible
Barcode failure should trigger a defined exception pathway.
Repeated failures should be captured as safety signals.
Workarounds should be studied, not normalized.
And where appropriate, the wristband can become something more: a secure digital token that connects the patient to a digital health experience.
Because patient identification is not just about technology.
It is about designing a system that still protects the patient when technology does not behave perfectly.
Barcode tells the system. Colour tells the team.
The image says it simply.
On one side, luggage tags show how aviation uses barcodes, visible tags and colour-coded alerts to move bags through a complex journey.
On the other side, a patient wristband and fall-risk alert show how health care uses similar principles to support identification, safety and awareness.
A barcode creates traceability.
A colour-coded alert creates visibility.
Human-readable information creates resilience when the scan fails, provided the information remains legible. Often if the barcode fails the human-readable information also fails.
A defined exception process protects the team from having to improvise under pressure.
And a secure wristband token can help connect the patient to the right digital experience.
Barcode tells the system. Colour tells the team. Readable identity protects the patient when the scan fails. A secure wristband token can support the next generation of patient authentication.
The future of patient identification is not just a better barcode.
It is a more resilient identity system.
And when the system depends too heavily on frontline improvisation, that is not resilience.
That is risk.
That is the next conversation health care needs to have.
About Medirex Systems Inc.
Medirex Systems Inc. (Medirex) is a Canadian-owned and operated business connecting patients to health information systems. Being an industry leader for over 50 years, Medirex has evolved to bridge the gap between patient identification and engagement by cultivating patient connections with ease, security, and no errors. Providing a positive patient identification experience for over 10 million Canadians, Medirex adopts technologies ensuring that the patient has a voice in their healthcare journey. Medirex aids in the adoption of digital health resources and data to improve the patient experience for your healthcare organization.
Media Contact:
Medirex Communications
Medirex Systems Inc.
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