Authors
Cameron Demee-Fong (biography, no disclosures), Brian Yong MD (biography, no disclosures), Preena Sahota MD (biography, no disclosures) and Manstein Kan MD (biography and disclosures)
Dr. Manstein Kan’s disclosures: Has received speakers’ honoraria, consulted for and participated in medical advisory board programs for AstraZeneca, Medexus Pharmaceuticals, Aralez and Pfizer. Treatments or recommendations in this article are unrelated to products/services/treatments involved in disclosure statements.
Acknowledgements: We would like to thank Michelle Briere, Director of Strategic Initiatives at Pathways BC, for her input on this article.
What we did before
Allergy and clinical immunology clinic
In a typical allergy and immunology office visit, patients are provided with multiple paper leaflets on various topics, including allergy immunotherapy, dust mite avoidance measures and allergic rhinitis management, among others.
While handouts are useful, they have become cumbersome and are not environmentally friendly. Furthermore, many of our patients prefer digital copies and often contact our office after misplacing the handout, requesting that the information be resent.
Primary care clinic
With a growing emphasis on engaging primary care patients, the reliance on paper charting, pamphlets and information cards is declining. Alongside the widespread use of smartphones and digital navigation tools, many patients are becoming more climate-aware and making a conscious decision to minimize the use of paper.
It is common for patients to misplace their appointment time cards or lose pamphlets, leading them to rely on phone calls with long wait times to speak with a receptionist, who may already be overwhelmed with patients in the clinic space.
What changed our practice
We explored the use of Quick Response (QR) codes and URL shorteners to help disseminate important patient information. The advantages are that they reduce paper usage, reduce calls from patients requesting information to be resent and reinforce important logistical information about clinic locations, hours and appointment bookings, even outside clinic hours. Pathways BC has thousands of approved handouts on different topics, which can be emailed to patients from a no-reply email, or unique URLs can be used to create QR codes.
What do we do now
Allergy and clinical immunology clinic
We added three QR codes to our standard allergy skin test results, linking to our most commonly used handouts: an allergy immunotherapy information sheet, dust mite avoidance measures and resources on penicillin allergy and the benefits of delabeling. These are frequently referenced materials that patients may wish to review again at home after discussion following a typical office visit.
The QR code for resources on penicillin allergy creates an additional opportunity for patients with a penicillin allergy label to review the benefits of delabeling at home. During busy clinical visits, the benefits of delabeling may not be fully emphasized. Providing this information via QR code reinforces the benefits and may encourage patients to pursue a follow-up visit for penicillin delabeling.
In our experience, most patients prefer using QR codes rather than paper handouts. Not all patients require these resources; therefore, during a visit, patients are informed if the materials would be beneficial and are given the option to receive the information either as a printed handout or via a QR code.
Primary care setting
In the primary care setting, we have incorporated a QR code into our custom vinyl door decals outside each of the three clinic sites. This allows patients to easily access clinic information by scanning the QR code, even when the clinic is closed. Patients have commented that they like the ease of finding clinic information and that it is available at all hours.
Furthermore, in creating these QR codes, we learned about shortening URL codes. This has been important in ensuring that our patients are efficiently directed to important information in a timely fashion. We used the TinyURL website.
We have provided a step-by-step tutorial on using Pathways BC, creating QR codes and shortening URLs, appended to the end of this article.
Ensuring current information
As the contents of patient information handouts may evolve, it’s important to ensure patients are accessing the most up-to-date information, and some physicians may be concerned about maintaining multiple QR codes for their practice.
Creating an information maintenance schedule is essential to maintaining accurate and timely information. A clinic, whether a primary care or specialist practice, can establish a timeline for periodic evaluations of all content associated with QR codes. This may occur on a semi-annual basis or coincide with updates in clinical protocols. A checklist could be created to ensure that elements such as treatment guidelines, operational information (e.g., clinic hours) and patient educational resources remain current.
Additionally, establishing a mechanism for patient feedback regarding the relevance and clarity of QR-linked information is paramount. This will allow clinics to identify areas that require more resources.
QR codes and URL shorteners are vulnerable to cybersecurity attacks as well as scams.1 A scam can include replacing a QR code or URL shortener with a fake one leading patients to another website, possibly requesting patient data or other personal information. It is important for clinics to regularly scan QR codes and URL shorteners to ensure the links are current. Patients using QR codes or URL shorteners should also be aware of checking linked sites for authenticity. As a precaution, none of the authors have used QR codes to request patient data.
Using content found in Pathways BC has the advantage that it can be updated without the need to change the QR code or shortened URL. Clinicians can use existing content found in Pathways and can also request their handouts to be uploaded to Pathways. Pathways also has the additional advantage of increased security and privacy, particularly if using the email function inside the system.
Conclusion
We have provided experiences from both primary care and allergy and clinical immunology clinics in applying QR codes and URL shorteners to our practices. In both settings, QR codes have improved the dissemination of important patient information, whether this is in the form of handouts, office opening hours or clinic locations in custom door decals. QR codes can be easily created with the steps outlined below and are environmentally friendly. Pathways BC is a valuable platform that provides clinicians with up-to-date patient resources accessible via URLs. These links can be used to generate QR codes for easy sharing with patients or to send materials directly via a secure, no-reply email.
Some patients will still prefer paper copies of documents. As such, we still have paper copies of handouts, as well as a phone number that patients can call to determine the clinic location and hours of operation.
There are other great opportunities for the application of QR codes in clinical medicine. Already, QR codes are used in hospitals for patient identification in wristbands, patient blood work, medications and biopsy reports, to name a few.1,2 QR codes are easy to create and modify, adaptable and highly recognized by patients.
Resources for healthcare providers
Scan the QR code below to view and download instructions on creating QR codes and integrating links from Pathways BC and Google. Download PDF.
References
- Hayes WC. Using QR Codes to Connect Patients to Health Information. Ann Fam Med. 2017;15(3):275. doi:10.1370/afm.206 (View)
- Monk T, Graham N, Kausky K, Thomasse M, Gallagher R. Practice tip (for BC practitioners) utilizing Pathways BC beyond specialist lookups—finding patient handouts, requisitions, point‑of‑care tools. This Changed My Practice. March 22, 2022. Accessed February 18, 2026. (View)
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