title: Parent report and electronic medical record agreement on asthma education provided and children's tobacco smoke exposure.
abstract: OBJECTIVE
  To examine the concordance between parent report and electronic medical record documentation of asthma health education provided during a single clinic visit and second-hand tobacco smoke exposure among children with asthma.
  
  
  METHODS
  Parents of children with asthma were recruited from two types of clinics using different electronic medical record systems: asthma-specialty or general pediatric health department clinics. After their child's outpatient visit, parents were interviewed by trained study staff. Interview data were compared to electronic medical records for agreement in five categories of asthma health education and for the child's environmental tobacco smoke exposure. Kappa statistics were used to identify strength of agreement. Chi square and t-tests were used to examine differences between clinic types.
  
  
  RESULTS
  Of 255 parents participating in the study 90.6% were African American and 96.1% were female. Agreement was poor across all clinics but was higher within the asthma specialty clinics than the health department clinics for smoke exposure (κ = 0.410 versus 0.205), asthma diagnosis/disease process (κ = 0.213 versus -0.016) and devices reviewed (κ = 0.253 versus -0.089) with parents generally reporting more education provided. For the 203 children with complete medical records, 40.5% did not have any documentation regarding smoking exposure in the home and 85.2% did not have any documentation regarding exposure elsewhere.
  
  
  CONCLUSIONS
  We found low concordance between the parent's report and the electronic medical record for smoke exposure and asthma education provided. Un- or under-documented smoke exposure and health education have the potential to affect continuity of care for pediatric patients with asthma.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama , Birmingham, AL , USA .
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Harrington
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Haven
authors.forename: Velia Leybas
authors.initials: VL
authors.lastname: Nuño
authors.forename: Theresa
authors.initials: T
authors.lastname: Magruder
authors.forename: William C
authors.initials: WC
authors.lastname: Bailey
authors.forename: Lynn B
authors.initials: LB
authors.lastname: Gerald
mesh_terms: D000407:Alabama / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology*; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010290:Parents; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution