Using Barcodes for Managing Vaccines Stocks PUBLIC HEALTH INSTUTITE OF TURKEY DEPARTMENT OF VACCINES PREVENTABLE DISEASES Dr. Ahmet Ozlu Dr Osman Erkan Say 1
Core data: Total population 74.7 mln Birth cohort 1.26 mln Infant deaths 11 /1000 Climate varies: from hot summers to cold winters Country overview: Health Transformation Programme 2003-2010 Rapid health improvements & demographic change Increased availability of health resources and services Improved health financing - 7% of GDP 2
Immunization schedule & target diseases 1995 (6 antigens) BCG Diphtheria Pertussis Tetanus Measles Polio (Oral) 2002 (7 antigens) BCG Diphtheria Pertussis Tetanus Measles Polio (Oral) Hepatitis B 2010 (11 antigens) BCG Diphtheria Pertussis (acel.) Tetanus Measles Polio (Oral) Polio (Inactiv) Hepatitis B Hib Rubella Mumps, PCV 2012 (13 antigens) BCG Diphtheria Pertussis (acel.) Tetanus Measles Polio (Oral) Polio (Inactiv) Hepatitis B Hib Rubella Mumps, PCV Hepatitis A Varicella Source: Turkey Health Transformation Program Evaluation Report (2003-2010) & MoH Turkey 3
Turkey MoH investment in vaccines Source: Turkey Health Transformation Program Evaluation Report (2003-2010) 4
Vaccine products and supply (2011) Product BCG Hepatitis B DTPa-Hib-IPV DTP-IPV Td OPV MMR PCV Total Presentation Doses/vial 20 1 1 1 1 10 1 1 No. of doses /year 3 mln 5 mln 6 mln 1.5 mln 6 mln 2 mln 2.6 mln 6 mln 30.1mln Source: WHO/UNICEF Joint Reporting Form, 2011 5
Immunization supply chain Central vaccine store Province Public Health Directorate District Public Health Center Service delivery sites 3 months 1 month 1 month 1 81 950 22000 # of trucks: 7 # of transfer vehicle: 81 6
Vaccine Information System (Aşı-net) Management Vaccine Information System (Aşı-net) Stock Control Temperature Control
Integrated Health Information System Stock Control Temperature Control Vaccine Information System (Aşı-net) Management Family Medicine Information System (AHBS) Decision Support System (KDS) Hospital Information System (HBS)
2D barcode reading who uses it? Primary Vaccine Store Provincial Vaccine Stores Public Health Centers Family Physicians Public & Private Hospitals Clinics 1 81 950 22000 # of trucks: 7 # of transfer vehicle:81 9
What data contain a 2D barcode in Turkey? Name of vaccine and National Drug code Name of the manufacturer Batch no. Expiry date Parcel Box MoH standard data matrix structure and breakdown 10
Where the barcode is applied? DATA MATRİX LEVELS PARCEL PACKAGE BOX VİAL 11
Applying 2D barcodes - How it works? 2D barcodes generated after uploading the vaccine information Individual 2D barcodes are produced per Parcel/Package/Box/Vial 2D barcodes Secondary labelling done manually 12
Parcel Applied 2D barcodes - Examples Package Box Primary Package Each vials are in single dose presentations 13
2D barcode - How it works at service delivery? Family Physician Centers & Public Hospitals Operate their Patient Data Systems by using private software complying to National Health Data Dictionary. When 2D squarecode is scanned provision is taken from the Vaccine Stock System information regarding consumption of vaccine is sent to both Vaccine Stock System and to Central Data Bank of Health Information System.
Implementing 2D barcodes: lessons learnt - I Legal support and standards Integrated with the National Pharmaceuticals Tracking System (PTS) 2D barcodes mandatory by national legislation 1 July 2010 (2n version August 2012) National Health Data Dictionary, (USVS) has been developed and implemented Secondary labelling required
Implementing 2D barcodes: lessons learnt - II Time-table: Software development 3 years 2D barcode implementation 1 year Training (2 days training) National trainers 240 pers. Cascade training 1000 pers. Costs Equipment & Running Costs < 0.01$/dose
Impact & benefits of using 2D barcodes Patient safety and immunization surveillance Prevent vaccine administration errors Match individual immunization data & vaccine product information Matching vaccine & the cold chain monitoring Respond quickly to safety concerns Locate persons vaccinated with a specific lot Improved management of recalled lots. 17
Impact of 2D barcode in vaccines -II Stock management Prevent stock management errors Estimate needs and take appropriate actions Prevent stock-outs Expiry date warnings reduce/prevent wastage Real time tracking of Stock at each level (Wastage, Stock Balance and Demands) Stock level by lot and expiry date at each supply level Optimize the cost of stocks Save the time on producing documents Improve reporting and statistics 18
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