Parents as direct contributors to the medical record: validation of their electronic input.
OBJECTIVE
We assessed the validity and completeness of data in the past medical history (PMH) obtained electronically from parents and examined effects of the human-computer interface and sociodemographic variables on electronic parental report.


METHODS
We compared parents' electronic report of PMH data with a criterion standard, structured face-to-face interview by a pediatrician blinded to the electronic data. The electronic medical record interface enabled parents to provide 5 elements of the PMH: birth status, allergies, current medications, immunization status, and previous hospitalizations. The setting was the emergency department waiting room in an academic, urban children's hospital; parents of infants up to 12 months old participated. Outcome measures were validity of the PMH data obtained using the electronic medical record interface and odds of having an invalid or incomplete response using the electronic medical record interface.


RESULTS
One hundred parents were enrolled (69.4% of eligible subjects). Study subjects did not differ from nonenrollees on demographic variables and visit characteristics. The validity of the electronic medical record interface data was high across the PMH elements (94% to 99%). Two demographic features predicted invalid response: parental primary language other than English or Spanish (odds ratio [OR] 11.4, 95% confidence interval CI 1.7 to 76.3), and Asian ethnicity (OR 14. 6, 95% CI 1.2 to 182.4). Incomplete responses were predicted by limited previous experience with computers; computer-naive subjects had an eightfold increased odds of skipping a question (OR 7.9, 95% CI 1.8 to 34.6).


CONCLUSIONS
Parents are accurate independent reporters of their infants' general PMH using the electronic medical record interface. Their participation in care may be enhanced by allowing them to contribute medical information directly to the electronic medical record.
Porter
S C
SC
Divisions of Emergency Medicine and General Pediatrics, Informatics Program, Children's Hospital, Boston, MA 02115, USA. porter_s@a1.tch.harvard.edu
Silvia
M T
MT
Fleisher
G R
GR
Kohane
I S
IS
Homer
C J
CJ
Mandl
K D
KD
D001292:Attitude to Computers; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005240:Feasibility Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health; D008297:Male; D008487:Medical History Taking / Q000379:methods*; D016347:Medical Records Systems, Computerized; D010290:Parents / Q000523:psychology; D015203:Reproducibility of Results; D012923:Social Class