Electronic patient-provider communication: Will it offset office visits and telephone consultations in primary care?

被引:96
作者
Bergmo, TS
Kummervold, PE
Gammon, D
Dahl, LB
机构
[1] Univ Hosp N Norway, Norwegian Ctr Telemed, N-9038 Tromso, Norway
[2] Univ Hosp N Norway, Dept Paediat, Tromso, Norway
[3] Univ Tromso, Inst Clin Med, Tromso, Norway
关键词
electronic patient-provider communication; secure messaging system; resource use; primary care; randomised controlled trial;
D O I
10.1016/j.ijmedinf.2005.06.002
中图分类号
TP [自动化技术、计算机技术];
学科分类号
0812 ;
摘要
Background and aim: Electronic patient-provider communication promises to improve efficiency and effectiveness of clinical care. This study aims to explore whether a secure web-based messaging system is an effective way of providing patient care in general practices. Method: We conducted a randomised controlled trait and recruited 200 patients from the waiting area in one primary clinic in Norway. Participants were randomised to either the intervention group, which received access to a secure messaging system, or the control group receiving standard care without such access. Primary outcome measures were number of online consultations, telephone consultations and office visits in the two groups. Data were derived from patient records and collected 1 year prior to (baseline), and 1 year after the intervention. Results: Forty-six percent of the patients who were given access to the messaging system (n = 99) used the online communication system on at least one occasion (ranging from 1 to 17 messages per patient per year). A total of 147 electronic messages were sent to six general practitioners during a 1-year trial period. Eleven percent of the messages were to schedule an appointment. In 10% of the messages, the GP was unable to respond adequately and recommended an office visit. The reduction in office visits over time was greater for the intervention group than for the control group (P = 0.034). There was however no significant difference in the number of telephone consultations between the groups during the study (P=0.258). Conclusion: The use of a secure electronic messaging system reduced the number of office visits at the general practice, but not phone consultations. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:705 / 710
页数:6
相关论文
共 11 条
[1]   Email consultations in health care: 1-scope and effectiveness [J].
Car, J ;
Sheikh, A .
BMJ-BRITISH MEDICAL JOURNAL, 2004, 329 (7463) :435-438
[2]  
Couchman GR, 2001, J FAM PRACTICE, V50, P414
[3]   Electrons in flight - E-mail between doctors and patients [J].
Delbanco, T ;
Sands, DZ .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (17) :1705-1707
[4]  
FRIDSMA D, 1994, P ANN S COMP APPL ME, P5
[5]   What next for electronic communication and health care? New tools that require new thinking [J].
Jadad, AR ;
Delamothe, T .
BRITISH MEDICAL JOURNAL, 2004, 328 (7449) :1143-1144
[6]   Effect of a triage-based E-mail system on clinic resource use and patient and physician satisfaction in primary care - A randomized controlled trial [J].
Katz, SJ ;
Moyer, CA ;
Cox, DT ;
Stern, DT .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2003, 18 (09) :736-744
[7]  
Kummervold Per Egil, 2004, Tidsskr Nor Laegeforen, V124, P2633
[8]  
Moyer CA, 2002, AM J MANAG CARE, V8, P427
[9]  
Moyer CA, 1999, AM J MANAG CARE, V5, P1513
[10]  
NIELL R, 1994, ARCH FAM MED, V3, P268