Benefits in utilizing barcode technology in EMR at a community health center: Findings and implications from a mixed-methods evaluation

Background: Utilization of Electronic Medical Records (EMR) has greatly improved many aspects of health center operations particularly in documentation of patient record. However, vaccine documentation in EMR is tedious and prone to human error as it requires several mouse-clicking and data entry of multiple items. The documentation process affects nursing staff efficiency and documentation accuracy particularly in pediatric visits receiving up to six vaccines. Methods: At the Charles B. Wang Community Health Center (CBWCHC), barcode technology was implemented in 2007 to automate vaccine documentation and thus improve efficient use of EMR in nursing care. An inter-departmental taskforce consisting of nurses, administrators, IT and CI staff planned the implementation process, which included workflow re-design, nursing training, and revision of EMR vaccine templates. An evaluation was conducted on a pre-post basis to assess the benefits of barcode technology implementation in three areas – (1) vaccine documentation efficiency, (2) documentation accuracy and (3) staff satisfaction. Results: Review of clinical flow through a pre- and post-implementation time study and analysis of the charting of vaccine lot number data showed improved efficiency and accuracy in documentation. Self-administered surveys given to the nursing staff also showed increased satisfaction post-implementation. Conclusion: Barcode technology facilitates the process of vaccine documentation with increased efficiency and accuracy, as well as increasing nursing staff satisfaction in a busy ambulatory pediatric community healthcare setting. The findings suggest that barcode technology can be a promising innovation for healthcare facilities, especially in improving clinical operations and patient care.