Parent-driven technology for decision support in pediatric emergency care. Export

@article{citeulike:5730496, abstract = {BACKGROUND: A quasi-experimental intervention study composed of control and intervention periods was conducted to determine if a parent-driven health information technology influenced completeness of documentation and adherence to evidence-based emergency care for children. METHODS: Structured chart abstraction was used to assess documentation and correctness of clinical actions at test ordering, medication prescribed for disease, and medication ordered for pain in a tertiary care pediatric emergency department and a suburban general emergency department. During the intervention periods, parents of children who presented with complaints related to otitis media, urinary tract infection, head trauma, or asthma entered data into a health information technology (ParentLink), which produced treatment plans in the context of evidence-based guidelines. RESULTS: Of 1,410 subjects analyzed, 1,072 (76\%) were assigned to one of four disease categories: urinary tract infection (22\%), otitis media (20\%), asthma (11\%) and head trauma (47\%). During ParentLink use, documentation of pain significantly improved (28\% incomplete [control] versus 15\% [intervention], p = .003). Incorrect actions for pain treatment decreased, but not significantly (33\% [control] versus 24\% [intervention], p = .13). ParentLink did not influence actions for test ordering or prescribing for disease. DISCUSSION: Parent-driven health information technology intended to translate parents' knowledge into clinical practice and to support evidence-based care suggested a trend toward modest impact on pain management but did not demonstrate broad effects across diseases or care processes. The emergence and proliferation of personally controlled health records (PCHRs) presents opportunities for patients and parents to control their medical profiles. Although ParentLink is not a comprehensive PCHR, it represents a step in incorporating parent-derived information into medical decision making.}, author = {Fine, Andrew M. and Kalish, Leslie A. and Forbes, Peter and Goldmann, Donald and Mandl, Kenneth D. and Porter, Stephen C.}, citeulike-article-id = {5730496}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/19565690}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=19565690}, issn = {1553-7250}, journal = {Joint Commission journal on quality and patient safety / Joint Commission Resources}, keywords = {decisionsupport, emr, phr}, month = {June}, number = {6}, pages = {307--315}, posted-at = {2009-09-06 23:16:21}, priority = {2}, title = {Parent-driven technology for decision support in pediatric emergency care.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/19565690}, volume = {35}, year = {2009} }

TY - JOUR ID - citeulike:5730496 L3 - citeulike-article-id:5730496 N2 - BACKGROUND: A quasi-experimental intervention study composed of control and intervention periods was conducted to determine if a parent-driven health information technology influenced completeness of documentation and adherence to evidence-based emergency care for children. METHODS: Structured chart abstraction was used to assess documentation and correctness of clinical actions at test ordering, medication prescribed for disease, and medication ordered for pain in a tertiary care pediatric emergency department and a suburban general emergency department. During the intervention periods, parents of children who presented with complaints related to otitis media, urinary tract infection, head trauma, or asthma entered data into a health information technology (ParentLink), which produced treatment plans in the context of evidence-based guidelines. RESULTS: Of 1,410 subjects analyzed, 1,072 (76%) were assigned to one of four disease categories: urinary tract infection (22%), otitis media (20%), asthma (11%) and head trauma (47%). During ParentLink use, documentation of pain significantly improved (28% incomplete [control] versus 15% [intervention], p = .003). Incorrect actions for pain treatment decreased, but not significantly (33% [control] versus 24% [intervention], p = .13). ParentLink did not influence actions for test ordering or prescribing for disease. DISCUSSION: Parent-driven health information technology intended to translate parents' knowledge into clinical practice and to support evidence-based care suggested a trend toward modest impact on pain management but did not demonstrate broad effects across diseases or care processes. The emergence and proliferation of personally controlled health records (PCHRs) presents opportunities for patients and parents to control their medical profiles. Although ParentLink is not a comprehensive PCHR, it represents a step in incorporating parent-derived information into medical decision making. IS - 6 JF - Joint Commission journal on quality and patient safety / Joint Commission Resources SN - 1553-7250 EP - 315 TI - Parent-driven technology for decision support in pediatric emergency care. VL - 35 SP - 307 KW - decisionsupport KW - emr KW - phr AU - Fine, Andrew AU - Kalish, Leslie AU - Forbes, Peter AU - Goldmann, Donald AU - Mandl, Kenneth AU - Porter, Stephen PY - 2009/06// UR - http://view.ncbi.nlm.nih.gov/pubmed/19565690 ER -