title: ClinfoTracker: a generalizable prompting tool for primary care.
abstract: BACKGROUND
  ClinfoTracker is a prompt and reminder system designed as a platform for the study of the cognitive aspects of prompting in primary care. We examined the impact of ClinfoTracker in three practices and its potential for studying primary care clinicians' use of prompt and reminder systems.
  
  
  METHODS
  We studied ClinfoTracker in three practices using an observational design. We measured performance rates of three services during the course of 5 years in one practice and prompt response rates in all three practices for 5 months after implementation. We performed qualitative cognitive task analyses of ClinfoTracker use.
  
  
  RESULTS
  Five-year compliance rates increased for fecal occult blood testing (1996-2000, 22.5%, P = .0037; 1997-2000, 23.5%, P = .0024) and type 2 diabetes retinopathy testing (1997-2000, 15.7%, P = .0004; 1998-2000, 16.9%, P = .0001; 1999-2000, 12.4%, P = .0048). ClinfoTracker response rates from the three practices showed significant increases during 5 months (P < .0001). Significant differences seen between practice response rates indicate variable success in ClinfoTracker implementation. Cognitive task analyses performed at site 1 indicate differences in how ClinfoTracker prompts are incorporated into practice.
  
  
  CONCLUSIONS
  Improvements in preventive and disease management services after implementation show the potential of ClinfoTracker. Differences in implementation between practice sites and observations of individual clinicians show the promise ClinfoTracker holds for studying clinician use of prompt and reminder systems.
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor 48109, USA.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Nease
authors.forename: Lee A
authors.initials: LA
authors.lastname: Green
mesh_terms: D000704:Analysis of Variance; D003071:Cognition; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D003930:Diabetic Retinopathy / Q000517:prevention & control*; D005194:Family Practice / Q000379:methods; D006801:Humans; D007388:Internal Medicine / Q000379:methods; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000379:methods; D009780:Occult Blood; D010349:Patient Compliance / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods*; D017010:Reminder Systems; D013647:Task Performance and Analysis; D013997:Time Factors; D014481:United States; D016526:Workload