Parents as direct contributors to the medical record: Validation of their electronic input

Study objectives: We assessed the validity and completeness of data in the past medical history (PMH) obtained electronically from parents and examine d effects of the human-computer interface and sociodemographic variables on electronic parental report. Methods: We compared parents' electronic report: of PMH data with a criteri on standard, structured face-to-face interview by a pediatrician blinded to the electronic data. The electronic medical record interface enabled paren ts to provide 5 elements of the PMH: birth status, allergies, current medic ations, immunization status, and previous hospitalizations. The setting was the emergency department waiting room in an academic, urban children's hos pital; parents of infants up to 12 months old participated. Outcome measure s were validity of the PMH data obtained using the electronic medical recor d 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). St udy subjects did not differ from nonenrollees on demographic variables and visit characteristics. The validity of the electronic medical record interf ace data was high across the PMH elements (94% to 99%). Two demographic fea tures predicted invalid response: parental primary language other than Engl ish or Spanish (odds ratio [OR] 11.4, 95% confidence interval [CI] 1.7 to 7 6.3), and Asian ethnicity (OR 14.6, 95% CI 1.2 to 182.4). Incomplete respon ses were predicted by limited previous experience with computers; computer- naive subjects had an eightfold increased adds of skipping a question (OR 7 .9, 95% CI 1.8 to 34.6). Conclusion: Parents are accurate independent reporters of their infants' ge neral PMH using the electronic medical record interface. Their participatio n in care may be enhanced by allowing them to contribute medical informatio n directly to the electronic medical record.