Peanut Allergy Documentation in Electronic Medical Records
Monday, March 5, 2018
South Hall A2 (Convention Center)
Michelle G. Manious, Jasmyn E. Atalla, Elizabeth A. Erwin, MD, David R. Stukus, MD FAAAAI, Irene Mikhail, MD

The electronic medical record (EMR) is an important tool for communication among providers. Use of the EMR for recording peanut allergy (PA) has not been investigated.


The EMR of a tertiary care medical center was reviewed for patients with at least one well child primary care visit between January 1 and December 31, 2016. Comparisons were made between children who had PA on their problem list (PL), updated by physicians, vs allergy list (AL) alone, updated by multiple individuals.


Of 884 charts reviewed, 453 charts had PA on PL and 872 had PA on AL. There were no differences in age or gender between children who did and did not have PA on PL. However, children with PA on their PL were more likely to have an allergy referral, evaluation by an allergist, additional food allergies, epinephrine prescriptions, and repeat peanut IgE levels (p<0.001 for each). Children with PA on PL were more likely to have peanut allergy confirmed by an allergist than children with PA on AL alone (OR 1.8, p=.01). Among children with PA on AL alone, 17% were considered tolerant to peanut, compared to 5% with PA recorded on PL (p<0.001). However, PL could not be relied upon to capture PA consistently, as 67% considered definitely PA by the allergist did not have PA on their PL.


There is inconsistency with how PA is communicated in the EMR, which was associated with significant differences in how PA is confirmed and managed.