Journal of Pediatrics
Vol 164 | No. 1 | January 2014 | Pages 1-222
http://www.jpeds.com/current

Personal Health Record Use and Association with Immunizations and Well-Child Care Visits Recommendations
Portions of this study were presented as a poster at Kaiser Permanente’s Hawaii Research Symposium, November 12, 2012, Honolulu, HI.
Jeffrey O. Tom, MD, MS, Chuhe Chen, PhD, Yi Yvonne Zhou, PhD
Received 20 May 2013; received in revised form 24 July 2013; accepted 22 August 2013. published online 14 October 2013.
Abstract
Objective
To determine the association of parental use of integrated personal health records (PHRs) with children’s adherence to immunization and well-child care (WCC) visit recommendations.

Study design
For the immunization and WCC visit measures, we retrospectively analyzed, respectively, 766 and 639 matched pairs at Kaiser Permanente (KP) Hawaii and 2795 and 2448 pairs at KP Northwest who were ≤31 days old at enrollment and continuously enrolled for 2 years between January 2007 and July 2011. The independent variable (≥1 PHR feature used vs none) was matched using propensity scores on parental and children characteristics. The dependent variables were 2 measures from the 2010 Healthcare Effectiveness Data and Information Set: combination 2 immunization (all immunizations vs <all) and number of WCC visits through 15 months old (≥6 vs <6). We conducted multivariate logistic, propensity score-matched regression adjusting for parents’ education and child’s continuity of care.

Results
Children whose parents used ≥1 PHR feature (vs none) had higher odds of adhering to the recommended immunizations only at KP Northwest (KP Hawaii: OR 1.1, 95% CI 0.8-1.4, P > .05; KP Northwest OR 1.2, 95% CI 1.0-1.3, P < .05). PHR use was associated with better adherence to WCC visit recommendations for both KP Hawaii (OR 1.9, 95% CI 1.3-2.9, P < .001) and KP Northwest (OR 2.5, 95% CI 2.1-2.9, P < .001).

Conclusions
Young children whose parents used a PHR were more likely to adhere to the recommended WCC visits in both regions but immunizations in only 1 region.