After-hours telephone access to physicians with access to computerized medical records. Experience in an inner-city general medicine clinic.
The authors examined the effect of after-hours telephone access to physicians and physician access to computerized medical records on hospitalizations and emergency room (ER) visits in an inner-city, adult, general medicine clinic. Patients were randomly assigned to a control (C) and two study groups (S1 and S2). Patients in study groups S1 and S2 had after-hours telephone access to physicians. Computerized medical records were accessible to physicians only for callers in study group S2. During the initial 18 months of study, only 7.6% of eligible patients called the after-hours service, a rate of 6 calls/1,000 patients/month (200 calls/1,849 patients/18 months). Repeated promotion of the service was subsequently undertaken, and 19.4% of the patients used the service during the final 12 months of study, a rate of 24.1 calls/1,000 patients/month (467 calls/1,616 patients/12 months). There were no significant differences in hospitalizations or ER visits among the control and two study groups.
D003201:Computers; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D006746:Hospital Bed Capacity, 500 and over; D006760:Hospitalization; D006801:Humans; D007196:Indiana; D007256:Information Systems; D008498:Medical Record Linkage; D008499:Medical Records; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D011897:Random Allocation; D013689:Telephone; D013997:Time Factors