What are home-based records?

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UNI77087 letter

A home-based record is a medical document—more often physical rather than electronic—issued by a health authority—such as a national, provincial, state or district health department—on which an individual’s history of primary healthcare services (e.g., vaccinations) received is recorded. In contrast to a facility-based record, the home-based record is maintained in the household by an individual or their caregiver.

Home-based records are an important component of immunization service delivery. When well-designed, available in adequate supply, widely adopted and appropriately utilized, home-based records (HBRs) complement facility-based records within routine health information systems by providing a standardized form for legibly recording an individual’s vaccination history in an organized and consistent manner for future reference and review (a wiki describing the home-based record in further detail can be found here).

HBRs serve as an important information resource to enhance health professionals’ ability to make clinical decisions with the potential to enhance continuity of care and alleviate risks such as missed opportunities for delivering vaccination as well as unnecessarily re-vaccination that may be associated with absent or suboptimal documentation within health facilities.

Importantly, HBRs also serve as a point of reference around which health care providers may start discussions with individuals or their caregivers and empower them to make informed decisions about their healthcare.

Finally, because HBRs serve as a source of documented evidence of an individual’s vaccination history, they play an important role beyond direct clinical care including within quality of care management and public health monitoring through vaccination coverage surveys.

Unfortunately, the HBR is too often unable to fulfil its intended purpose because:

  • the HBR is not available in the right place, at the right time and/or in the right quantity;
  • the HBR is not appropriately referenced, used and legibly completed by health care workers at the time of service; and/or
  • the HBR is not fully owned, valued and utilized by individuals or their caregivers as an important document.

We continue to understand the reasons that underlie these HBR system failures in order to identify corrective actions. We believe this site is an important part of that process, and we look forward to its continued improvement.