title: Evaluation of scanning 2D barcoded vaccines to improve data accuracy of vaccines administered.
abstract: Accurately recording vaccine lot number, expiration date, and product identifiers, in patient records is an important step in improving supply chain management and patient safety in the event of a recall. These data are being encoded on two-dimensional (2D) barcodes on most vaccine vials and syringes. Using electronic vaccine administration records, we evaluated the accuracy of lot number and expiration date entered using 2D barcode scanning compared to traditional manual or drop-down list entry methods.
  
  
  
  We analyzed 128,573 electronic records of vaccines administered at 32 facilities. We compared the accuracy of records entered using 2D barcode scanning with those entered using traditional methods using chi-square tests and multilevel logistic regression.
  
  
  
  When 2D barcodes were scanned, lot number data accuracy was 1.8 percentage points higher (94.3-96.1%, P<0.001) and expiration date data accuracy was 11 percentage points higher (84.8-95.8%, P<0.001) compared with traditional methods. In multivariate analysis, lot number was more likely to be accurate (aOR=1.75; 99% CI, 1.57-1.96) as was expiration date (aOR=2.39; 99% CI, 2.12-2.68). When controlling for scanning and other factors, manufacturer, month vaccine was administered, and vaccine type were associated with variation in accuracy for both lot number and expiration date.
  
  
  
  Two-dimensional barcode scanning shows promise for improving data accuracy of vaccine lot number and expiration date records. Adapting systems to further integrate with 2D barcoding could help increase adoption of 2D barcode scanning technology.
authors.affiliation: Deloitte Consulting, LLP, 555-17th Street Suite 3600, Denver, CO 80202-3942, United States.
authors.forename: Ashley
authors.initials: A
authors.lastname: Daily
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, 1600 Clifton Road NE, Atlanta, GA 30329, United States.
authors.forename: Erin D
authors.initials: ED
authors.lastname: Kennedy
authors.affiliation: Claremont Graduate University, 150 E. 10th Street, Claremont, CA 91711, United States.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Fierro
authors.affiliation: Deloitte Consulting, LLP, 980 Ninth Street, Suite 1800, Sacramento, CA 95814, United States.
authors.forename: Jenica Huddleston
authors.initials: JH
authors.lastname: Reed
authors.affiliation: Deloitte Consulting, LLP, 200 Berkeley Street, Boston, MA 02116, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Greene
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, 1600 Clifton Road NE, Atlanta, GA 30329, United States.
authors.forename: Warren W
authors.initials: WW
authors.lastname: Williams
authors.affiliation: Deloitte Consulting, LLP, 1919 North Lynn Street, Arlington, VA 22209, United States.
authors.forename: Heather V
authors.initials: HV
authors.lastname: Evanson
authors.affiliation: Deloitte Consulting, LLP, 191 Peachtree Street, Suite 2000, Atlanta, GA 30303-1749, United States.
authors.forename: Regina
authors.initials: R
authors.lastname: Cox
authors.affiliation: Deloitte Consulting, LLP, 2500 One PPG Place, Pittsburgh, PA 15222, United States.
authors.forename: Patrick
authors.initials: P
authors.lastname: Koeppl
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, 1600 Clifton Road NE, Atlanta, GA 30329, United States. Electronic address: kbg4@cdc.gov.
authors.forename: Ken
authors.initials: K
authors.lastname: Gerlach
mesh_terms: D000068598:Data Accuracy; D004282:Documentation / Q000592:standards; D001330:Electronic Data Processing / Q000379:methods* / Q000592:standards; D057286:Electronic Health Records / Q000592:standards; D006801:Humans; D015999:Multivariate Analysis; D011356:Product Labeling / Q000592:standards; D011786:Quality Control; D014481:United States; D014486:United States Food and Drug Administration; D014611:Vaccination / Q000592:standards*; D014612:Vaccines / Q000008:administration & dosage / Q000592:standards*
chemical_list: D014612:Vaccines
keywords: 2D barcode technology; Automatic data processing; Electronic health record; Immunization; Technology adoption; Vaccines