Computer-based vs manual health maintenance tracking. A controlled trial.
OBJECTIVE
To compare computer-based with manual health maintenance tracking systems to determine whether (1) a computer-based system will result in better provider compliance with the practice health maintenance protocol, (2) the incremental cost of operating a computer-based vs a manual health maintenance tracking system differs, and (3) inactive patients will respond to health maintenance reminders.


METHODS
Two-year prospective, randomized, controlled trial.


METHODS
Rural, multiple-office, nonprofit, fee-for-service family practice.


METHODS
Adult members of families in which at least one member had been seen by the practice within the past 2 years.


METHODS
A computer-based health maintenance tracking system that generated annual provider and patient reminders for all patients regardless of appointment status compared with a manual flowchart-based tracking system in which patient reminders were triggered by provider request.


METHODS
Provider compliance with the health maintenance protocol determined by preintervention and postintervention chart audits, costs of computer-based tracking, and response of inactive patients to health maintenance reminders.


RESULTS
Overall provider compliance with the health maintenance protocol increased 15 percentage points in the computer-based tracking group and four percentage points in the manual group. The computer-based tracking group had significantly higher provider compliance than the manual group for eight of 11 procedures. The computer-based tracking system cost 78 cents per patient per year to operate. It was not associated with increased office visits or patient billings.


CONCLUSIONS
Computer-based health maintenance tracking improved provider health maintenance compliance compared with a manual system. The finding that health maintenance compliance improved without a significant increase in patient visits or billings requires confirmation in other settings but suggests that considerable health maintenance can be incorporated into ongoing patient care.
Frame
P S
PS
Tri-County Family Medicine, Dansville, NY.
Zimmer
J G
JG
Werth
P L
PL
Hall
W J
WJ
Eberly
S W
SW
D000328:Adult; D000368:Aged; D000555:Ambulatory Care Information Systems / Q000191:economics / Q000592:standards*; D016009:Chi-Square Distribution; D003199:Computer Systems; D003710:Demography; D005194:Family Practice / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D010349:Patient Compliance; D011314:Preventive Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D011446:Prospective Studies; D017010:Reminder Systems / Q000191:economics / Q000592:standards*