An article detailing two researchers’ findings on the social life of paper health records in Social Science & Medicine received the 2015 Diana Forsythe Award from the American Medical Informatics Association in December, according to a recent news story.

OT_News-01Despite the ongoing transition to electronic health records nationwide, two researchers at the University of Southern California in Los Angeles have been digging into any remaining value of the traditional hard-copy records. Their article was selected as a co-recipient from a group of more than 30 other nominations, according to the story. The award is named in memory of Forsythe, who was a pioneer in the field of medical informatics.

For their research, occupational science doctorate candidate Amber Angell, MOT, OTR/L, and her mentor, Olga Solomon, PhD, MA, assistant professor in the USC Chan Division of Occupational Science and Occupational Therapy, looked at data from Solomon’s multidisciplinary urban ethnographic study, “Autism in Urban Context,” according to the USC News story by Mike McNulty. The study was funded by the National Institute for Mental Health.

To collect data for the study, the researchers followed 23 African-American families that included children diagnosed with autism spectrum disorder who lived in Los Angeles County. For about three years, investigators interviewed, observed and video-recorded the families in their homes, in physician’s offices, in their children’s schools and in the community. Many of the families faced persistent disparities in ASD diagnosis and interventions, according to the article.

The families were asked questions about how they used their child’s health records when seeking and obtaining ASD services, how the health records changed their interactions with healthcare professionals and how the records affected the families’ experiences, according to the story.

Records throughout the community

Angell and Solomon discovered records do not remain in medical contexts but rather traveled in cars, buses, bags and backpacks into homes, schools, clinics and the entire community. They later called this the “social life” of paper records. In the study, they note some parents brought thick, chronologically ordered binders filled with records and documents to meetings in schools and doctor’s offices, often as a way of validating their own knowledge and expertise to professionals.

The researchers also discovered how the subtleties of written descriptions in health records can have consequences beyond the delivery of care. For example, they found descriptions of parents’ employment status positively or negatively influenced clinicians’ perceptions of them. Parents told researchers if they were actively trying to show they were good parents, descriptions in medical records made the task more or less difficult.

The USC researchers point out that recognizing the social life of health records, whether they are in digital or analog formats, is critical for improving relationships between families and practitioners.

“Until recently, clinicians haven’t had to think much about how patients or families might feel about what’s written in their records,” Angell said in the story. “Now, as electronic health records are changing how patients and families engage with their records, this is something for clinicians to take into consideration.”

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