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Patients providing the answers: narrowing the gap in data quality for emergency care
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  1. Stephen C Porter1,2,
  2. Peter Forbes3,
  3. Shannon Manzi4,
  4. Leslie A Kalish3
  1. 1Department of Medicine, Division of Emergency Medicine, Children's Hospital Boston, Boston, Massachusetts, USA
  2. 2Children's Hospital Informatics Program @ Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, Massachusetts, USA
  3. 3Clinical Research Program, Children's Hospital Boston, Boston, Massachusetts, USA
  4. 4Department of Pharmacy, Children's Hospital Boston, Boston, Massachusetts, USA
  1. Correspondence to Dr Stephen C Porter, Division of Emergency Medicine, Main South CB0101, Children's Hospital Boston, Boston, MA 02115, USA; stephen.porter{at}childrens.harvard.edu

Abstract

Objective The authors examined the validity of documentation produced during paediatric emergency care to determine if a patient-driven health information technology called ParentLink produced higher-quality data than documentation completed by nurses and physicians.

Design The authors analysed the quality of information across elements of allergies to medications and the history of present illness (HPI) collected during a quasi-experimental intervention study where control periods with usual care alternated with intervention periods when ParentLink was operational. Documentation by emergency department (ED) providers was abstracted and compared with information generated through ParentLink. The criterion standard for the history of allergies to medications was a structured telephone interview with parents after the ED visit. A valid report for a medication allergy was one that was both accurate and complete. Completeness of the HPI for acute head trauma was evaluated across seven elements relevant to an evidence-based risk assessment.

Results Of 1410 enrolled parents, 1111/1410 (79%) completed the criterion standard interview. Parents' valid reports of allergies to medications were higher than those of nurses (parents 94%, nurses 88%, p<0.0001). Parents' valid reports of allergies to medications were greater than those of physicians (parent 94%, physicians 83%, p<0.0001). ParentLink produced more complete information on HPI for head trauma than the medical record for five of seven elements.

Conclusion ParentLink provided electronic information that met or exceeded the quality of data documented by ED nurses and physicians.

  • Paediatrics
  • emergency medicine
  • parent
  • medical history taking
  • patient-centred care
  • documentation
  • medical informatics
  • information science
  • assessment
  • communication
  • emergency department
  • information technology
  • patient-centred

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Footnotes

  • Funding This work was supported by grant R01 HS014947 to Dr Porter from the Agency for Healthcare Research and Quality.

  • Competing interests None.

  • Patient consent Obtained from the parents.

  • Ethics approval Ethics approval was provided by the Children's Hospital Boston, Boston, Massachusetts, USA and South Shore Hospital, Weymouth, Massachusetts, USA.

  • Provenance and peer review Not commissioned; externally peer reviewed.