Young children whose parents used an integrated personal health record were more likely to attend six or more of the nationally recommended well-child care visits by 15 months of age, according to a Kaiser Permanente study published today in The Journal of Pediatrics. Using any Web-enabled device, PHRs allow patients to view parts of their medical record, including immunizations and after-visit instructions, manage appointments, refill prescriptions, check lab results, and securely communicate with their health care providers.
In this retrospective study, researchers examined data for more than 7,000 children aged 0 to 2 years who were enrolled in Kaiser Permanente health plans in the Hawaii and Northwest regions between January 2007 and July 2011. In the Northwest, researchers found that children whose parents use Kaiser Permanente's personal health record at least once during the study period were 2.5 times more likely to attend all recommended well-child visits. In Hawaii, children whose parents used the PHR were twice as likely to attend all well-child visits.
The researchers also found that children whose parents used the PHR in the Northwest were 1.2 times more likely to receive their recommended immunizations; the results were statistically non-significant in Hawaii.
"For busy parents, it may be difficult to prioritize or remember when to bring their young children in for well-child care visits or immunizations, particularly when they are healthy," said Jeffrey Tom, MD, MS, FAAP, study lead author and assistant investigator at the Kaiser Permanente Center for Health Research. "Our study found that in two demographically and geographically distinct regions in the United States, PHRs appear to be a viable tool to help ensure children adhere to recommended preventive care."
More than 4.3 million members are registered to use Kaiser Permanente's personal health record, My Health Manager on kp.org. In the first half of this year alone, patients have viewed 17.5 million lab test results, sent 7.4 million secure emails to their care providers, refilled 7.1 million prescriptions and scheduled 1.8 million appointments. Members can also view their medical records and manage the health of their children and other family members.
The researchers used performance measures listed in the 2010 Healthcare Effectiveness Data and Information Set that state children aged 0-15 months should attend at least six well-care visits. The visits include a complete physical examination, with special attention paid to whether the child is meeting normal developmental milestones.
"We expect that PHRs are likely to become more fully integrated into patients' daily activities with the growing adoption of smartphones and the availability of PHR-enabled mobile applications," said Dr. Tom. "To maximize the benefits of this integration, PHRs will need to be continually improved with features that are most useful to patients."
Kaiser Permanente's My Health Manager and similar PHRs can help patients better manage their care by providing timely, easy access to important health information. If properly designed and implemented, PHRs can help patients manage their health information and become full partners in the quest for good health, according to the U.S. Department of Health and Human Services.
This study is part of Kaiser Permanente's ongoing efforts to deliver transformational health research regarding pediatric health. In May, Kaiser Permanente researchers found that young children who missed more than half of recommended well-child visits had up to twice the risk of hospitalization compared to children who attended most of their visits. The study, which included more than 20,000 children enrolled at Group Health Cooperative, also found that children with chronic conditions like asthma and heart disease were even more likely to be hospitalized when they missed visits.
- Tom JO, Chen C, Zhou YY. Personal health record use and association with immunizations and well-child care visits recommendations. Journal of Pediatrics, October 2013
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