Parents as partners in obtaining the medication history.
OBJECTIVE
Patient-centered information management may overcome barriers that impede high-quality, safe care in the emergency department (ED). The utility of parents' report of medication data via a multimedia, touch screen interface, the asthma kiosk, was investigated. Our specific aims were (1) to estimate the validity of parents' electronically entered medication history for asthma and (2) to compare the parents' kiosk entries regarding medications to the documentation of ED physicians and nurses.


METHODS
We enrolled a cohort of parents to use the asthma kiosk and tested the validity of this communication channel for medication data specific to pediatric asthma. Parents' data provided via the kiosk during the ED encounter and the documentation of ED nurses and physicians were compared with a telephone-based interview with the parent after discharge that reviewed all asthma-specific medications physically present in the home. Treating clinicians in the ED were blinded to the parents' kiosk entries.


RESULTS
Sixty-six parents were enrolled and 49 of 66 (74.2%) completed the gold standard interview. When analyzed at the level of individual medications, the validity of parental report was 81% for medication name, 79% for route of delivery, 66% for the form of the medication, and 60% for dose. Parents' report improved on the validity of documentation by physicians across all medication details save for medication name. Parents' report was more valid than nursing documentation at triage for all medication details.


CONCLUSIONS
Parents can provide an independent source of medication data that improves on current documentation for key variables that impact quality and safety in emergency asthma care.
Porter
Stephen C
SC
Division of Emergency Medicine, MA-001, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. stephen.porter@childrens.harvard.edu
Kohane
Isaac S
IS
Goldmann
Donald A
DA
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D003201:Computers; D004636:Emergency Service, Hospital; D006801:Humans; D007223:Infant; D008487:Medical History Taking; D008491:Medical Informatics Applications; D019212:Multimedia; D009726:Nurses; D010290:Parents; D010820:Physicians; D015203:Reproducibility of Results; D014584:User-Computer Interface
D018927:Anti-Asthmatic Agents