What to know
Since 2011, the CDC and its partners have been investigating the use of two-dimensional (2D) barcodes and scanning technology to enhance immunization processes, demonstrating through pilot projects that 2D barcode scanning improves vaccine record accuracy and efficiency, with ongoing initiatives aimed at promoting widespread adoption and collaboration among stakeholders in the immunization community.
Pilots
Since 2011, CDC and its partners have been exploring the potential of two-dimensional (2D) barcodes and barcode scanning to streamline immunization practices and improve data quality. Three pilot projects demonstrated that 2D barcode scanning can lead to improved vaccine record accuracy and time savings. Additional initiatives include exploring the practice of vaccine 2D barcode scanning, informing the immunization community of the pilot projects, increasing participation and collaboration among stakeholders, and advancing the practice of 2D barcode scanning are described below.
Description
Since prior pilots, there has been a dramatic increase in the number of 2D barcoded vaccines in the U.S. market on unit of use (UoU) (e.g., vial, syringe) products. In October 2015, CDC initiated a pilot to assess the impact of scalability of scanning 2D barcoded vaccines in a large health system, an organization of people, institutions, facilities, and resources that deliver health care services to a target population. The focus of the pilot on a single health system helped to converge on some of the challenges of implementation and removed the variability of different electronic medical record (EMR) software systems on the impact of vaccine 2D barcoding. This project investigated the information technology needs and clinical workflow practice adjustments when implementing 2D barcode scanning of vaccine UoU products in healthcare practices. Additional considerations included an evaluation of staff adherence to scanning, identification of workflow processes used for scanning across different healthcare practices, recognition of challenges experienced, and an assessment of the institutional impact of scanning.
Recruitment criteria for the large health system included the following:
- Interest and willingness to participate.
- Participation in prior pilots.
- Use of a single EMR system with 2D barcode functionality.
Sutter Health, “a family of doctors and hospitals serving more than 100 communities” and consisting of different health care practice settings (pediatric, family medicine, internal medicine, and vaccine clinics) was selected to participate based on the recruitment criteria.
Objectives
- Determine organizational strategies that can support successful implementation of vaccine 2D barcode scanning.
- Assess impact of scanning 2D barcoded vaccines on data quality and efficiency within a large health system.
- Observe the extent participants scanned 2D barcoded vaccines and assess how their adherence to scanning protocol could be increased.
- Evaluate the user experience of integrating vaccine 2D barcode scanning into a clinical workflow setting.
Among the 75 healthcare practice sites, or centers, within the Sutter Health system, 27 healthcare centers were selected to participate in the pilot. Participation included the installation and configuration of 2D barcode scanners within each center, staff training on how to scan the 2D barcoded products, and scanning of 2D barcoded vaccines for approximately six months. Clinicians at these centers were asked to scan the 2D barcode on the vaccine UoU prior to administration. Additionally, different strategies were implemented to encourage and increase adoption of scanning by clinicians across the 27 centers.
Report
Findings Report: 2D Vaccine Barcode Scanning Pilot [2 MB, 54 pages].
Description
In October 2013, CDC initiated a second pilot project to assess the impact of the introduction of 2D barcodes onto unit of use or primary vaccine products (e.g., vials, syringes). With the increased number of 2D barcoded vaccines on the market, this project expanded upon the intent of the 2D Vaccine Barcode Pilot (2011). This project evaluated the data captured and operational processes in various vaccine administration settings, which included physician settings, pharmacies, and mass vaccination clinics.
The project enlisted three vaccine manufacturers (GlaxoSmithKline, Merck, and Sanofi Pasteur) and approximately 90 immunizing facilities. A subset of the participating immunizers was selected to participate in a time and motion study to assess the impact of the use of 2D barcode scanners and 2D barcoded vaccine products on administration and inventory workflows.
Objectives
- Evaluate the effect of 2D barcodes on the completeness and accuracy of vaccine administration data.
- Obtain practitioner perspectives on 2D barcode scanning adoption and use.
- Observe the effect of 2D barcoded vaccines on practice inventory and vaccination operations.
Report
Summary Report: Reporting for the Adoption Strategies for 2D Barcode Project [38 pages]
Description
The 2D Vaccine Barcode Pilot’s (Pilot) Education Forum (Forum) was conducted April 14-15, 2013. Seventy-eight (78) immunization community stakeholders including vaccine manufacturers, public and private immunizing providers, and electronic medical record (EMR) vendors, Immunization Information Systems (IIS) staff, and 2D barcode scanner vendors came together to discuss successes, opportunities, challenges, and next steps for implementing 2D barcoding on vaccine products.
Speaker presentations and panel discussions shared insights gained through the CDC 2D Vaccine Barcode Pilot, vaccine manufacturer application of 2D barcodes, EMR and IIS enablement of 2D barcode scanning, and health care provider adoption of vaccine 2D barcode scanning into practice operations. Facilitated working sessions produced rich discussion on the foremost interests and concerns of the immunization community in the areas of 2D barcoded vaccine standards, adoption, and implementation.
The multiple immunization community perspectives represented at the Forum produced several valuable recommendations and helped to better define next steps to advance 2D barcoded vaccine scanning practices.
Report
Two-Dimensional (2D) Vaccine Barcoding Pilot Education Forum Report [54 pages]
Forum Presentations
Manager, Immunization Initiatives, American Academy of Pediatrics
Team Lead, Deloitte Consulting LLP
Medical Officer, CDC/NCIRD
Analytics Consultant, Deloitte Consulting LLP
Health Scientist, CDC/NCIRD
Senior Consultant, Deloitte Consulting LLP
Senior Consultant, Deloitte Consulting LLP
Description
A vaccine 2D barcoding manufacturers forum was conducted in January 2012 to inform manufacturers and other stakeholders about the pilot project and to identify challenges and potential solutions. Over 60 industry stakeholders attended, including representatives from vaccine manufacturing companies, retail pharmacies, standards organizations, as well as the World Health Organization (WHO), The Food and Drug Administration (FDA), and the CDC.
Report
Two-Dimensional (2D) Vaccine Barcoding Manufacturers Forum Report [32 pages]
Description
In September 2011, CDC initiated a pilot project to assess the impact of the introduction of 2D barcodes onto vaccines. Vaccination information was collected August 2012 through May 2013 from a variety of participants, including 10 immunization awardees and 217 public and private practices. During the pilot project, two vaccine manufacturers, GlaxoSmithKline and Sanofi Pasteur, were labeling vaccines with 2D barcodes.
Objectives
- Evaluate the effect of scanning 2D barcodes on the completeness and accuracy of vaccine administration data.
- Obtain practitioner perspectives on 2D barcode scanning adoption and use.
- Observe the effect of 2D barcoded vaccines on practice inventory and vaccination operations.
- Apply 2D barcodes to Vaccine Information Statements (VIS).
Reports
Implementation Pilot for Two-Dimensional (2D) Vaccine Barcode Utilization: Summary Report [27 pages]
Description
CDC initiated a study in 2010 of the impact of vaccine products with 2D barcodes on vaccine production, clinical documentation, and public health reporting. The data fields within the proposed 2D barcodes included product identification, lot number, and expiration date.
Objectives
- Document knowledge, attitudes, and beliefs about the impacts and implications of 2D barcodes on vaccine products.
- Assess societal, manufacturer, and healthcare provider economic benefits and costs, and the distribution of these costs and benefits across stakeholders.
- Review the exchange of health information and data standards relevant to 2D barcodes to assess how information can be transmitted across stakeholders. (This issue was particularly important as the United States was moving from primarily paper-based medical records system to electronic ones.) A feasibility assessment and a series of recommendations about how to incorporate the information captured from the 2D barcode into both the relevant standards and the guidance was produced.
Report