title: Incorporating scannable forms into immunization data collection processes: a mixed-methods study.
abstract: BACKGROUND
  Individual-level immunization data captured electronically can facilitate evidence-based decision-making and planning. Populating individual-level records through manual data entry is time-consuming. An alternative is to use scannable forms, completed at the point of vaccination and subsequently scanned and exported to a database or registry. To explore the suitability of this approach for collecting immunization data, we conducted a feasibility study in two settings in Ontario, Canada.
  
  
  RESULTS
  Prior to the 2011-2012 influenza vaccination campaign, we developed a scannable form template and a corresponding database that captured required demographic and clinical data elements. We examined efficiency, data quality, and usability through time observations, record audits, staff interviews, and client surveys. The mean time required to scan and verify forms (62.3 s) was significantly shorter than manual data entry (69.5 s) in one organization, whereas there was no difference (36.6 s vs. 35.4 s) in a second organization. Record audits revealed no differences in data quality between records populated by scanning versus manual data entry. Data processing personnel and immunized clients found the processes involved to be straightforward, while nurses and managers had mixed perceptions regarding the ease and merit of using scannable forms. Printing quality and other factors rendered some forms unscannable, necessitating manual entry.
  
  
  CONCLUSIONS
  Scannable forms can facilitate efficient data entry, but certain features of the forms, as well as the workflow and infrastructure into which they are incorporated, should be evaluated and adapted if scannable forms are to be a meaningful alternative to manual data entry.
authors.affiliation: Infectious Diseases, Public Health Ontario, Toronto, Ontario, Canada.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Heidebrecht
authors.forename: Susan
authors.initials: S
authors.lastname: Quach
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Pereira
authors.forename: Sherman D
authors.initials: SD
authors.lastname: Quan
authors.forename: Faron
authors.initials: F
authors.lastname: Kolbe
authors.forename: Michael
authors.initials: M
authors.lastname: Finkelstein
authors.forename: David L
authors.initials: DL
authors.lastname: Buckeridge
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Kwong
mesh_terms: D003625:Data Collection / Q000295:instrumentation* / Q000379:methods*; D001330:Electronic Data Processing / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D017589:Immunization Programs; D007252:Influenza Vaccines / Q000627:therapeutic use; D007251:Influenza, Human / Q000517:prevention & control; D015233:Models, Statistical; D009864:Ontario; D010865:Pilot Projects; D015203:Reproducibility of Results; D012107:Research Design; D012984:Software; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000379:methods*
chemical_list: D007252:Influenza Vaccines