title: Feasibility and Limitations of Vaccine Two-Dimensional Barcoding Using Mobile Devices.
abstract: Two-dimensional (2D) barcoding has the potential to enhance documentation of vaccine encounters at the point of care. However, this is currently limited to environments equipped with dedicated barcode scanners and compatible record systems. Mobile devices may present a cost-effective alternative to leverage 2D vaccine vial barcodes and improve vaccine product-specific information residing in digital health records.
  
  
  
  Mobile devices have the potential to capture product-specific information from 2D vaccine vial barcodes. We sought to examine the feasibility, performance, and potential limitations of scanning 2D barcodes on vaccine vials using 4 different mobile phones.
  
  
  
  A unique barcode scanning app was developed for Android and iOS operating systems. The impact of 4 variables on the scan success rate, data accuracy, and time to scan were examined: barcode size, curvature, fading, and ambient lighting conditions. Two experimenters performed 4 trials 10 times each, amounting to a total of 2160 barcode scan attempts.
  
  
  
  Of the 1832 successful scans performed in this evaluation, zero produced incorrect data. Five-millimeter barcodes were the slowest to scan, although only by 0.5 seconds on average. Barcodes with up to 50% fading had a 100% success rate, but success rate deteriorated beyond 60% fading. Curved barcodes took longer to scan compared with flat, but success rate deterioration was only observed at a vial diameter of 10 mm. Light conditions did not affect success rate or scan time between 500 lux and 20 lux. Conditions below 20 lux impeded the device's ability to scan successfully. Variability in scan time was observed across devices in all trials performed.
  
  
  
  2D vaccine barcoding is possible using mobile devices and is successful under the majority of conditions examined. Manufacturers utilizing 2D barcodes should take into consideration the impact of factors that limit scan success rates. Future studies should evaluate the effect of mobile barcoding on workflow and vaccine administrator acceptance.
authors.affiliation: Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada.
authors.forename: Cameron
authors.initials: C
authors.lastname: Bell
authors.forename: Julien
authors.initials: J
authors.lastname: Guerinet
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Atkinson
authors.forename: Kumanan
authors.initials: K
authors.lastname: Wilson
mesh_terms: D040421:Cell Phone; D003362:Cost-Benefit Analysis; D000068598:Data Accuracy; D004282:Documentation; D004348:Drug Labeling; D001330:Electronic Data Processing; D005240:Feasibility Studies; D006801:Humans; D019095:Point-of-Care Systems; D014611:Vaccination; D014612:Vaccines
chemical_list: D014612:Vaccines
keywords: automatic data processing; cell phones; feasibility studies; immunization; vaccinations/standards; vaccines