title: You've got mail … and need follow-up: the effect and patient perception of e-mail follow-up reminders after emergency department discharge.
abstract: OBJECTIVE
  The hypothesis was that a reminder about recommended primary care physician (PCP) follow-up, sent via e-mail to patients discharged from the emergency department (ED), would increase the proportion of patients who followed up with their PCPs within the recommended time frame. Patient receptiveness to e-mail follow-up reminders was also assessed.
  
  
  METHODS
  This was a mixed methods clinical intervention study with subjects randomized either to receive the usual care discharge instructions only or to also receive a reminder e-mail message the day after the ED visit. The reminder e-mail contained the subject's PCP's name and address and the recommended PCP follow-up time interval. A blinded review of outpatient PCP medical records was conducted to determine whether and when follow-up occurred. Researchers attempted to contact patients with a telephone survey 2 weeks after their ED visits. The primary outcomes between groups were compared using chi-square tests and relative risks (RRs) with 95% confidence intervals (CIs).
  
  
  RESULTS
  Thirty-three percent of the intervention group and 32% of the control group followed-up as recommended (RR = 1.04, 95% CI = 0.81 to 1.33); 52% of the intervention group and 48% of the control group followed-up within 10 days of the recommended time (RR = 1.08, 95% CI = 0.91 to 1.29). The 334 patients (57%) successfully contacted via telephone demonstrated a high interest in receiving future e-mail reminders (75%), with the group that received e-mail reminders more likely to want one in the future than those who did not receive e-mail reminders (82.5% vs. 69.76%; p = 0.04).
  
  
  CONCLUSIONS
  E-mail reminders sent after ED visits did not improve patients' adherence to the recommended timing of primary care follow-up contained in discharge instructions. Subjects in both the control and the intervention groups favorably viewed the concept of e-mail reminders, suggesting that the value of e-mail reminders after ED discharge may be in areas such as patient satisfaction that were not specifically targeted for measurement in this study.
authors.affiliation: Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Brian
authors.initials: B
authors.lastname: Sharp
authors.forename: Bonita
authors.initials: B
authors.lastname: Singal
authors.forename: Michael
authors.initials: M
authors.lastname: Pulia
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fowler
authors.forename: Stefanie
authors.initials: S
authors.lastname: Simmons
mesh_terms: D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D016009:Chi-Square Distribution; D034742:Electronic Mail; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010351:Patient Discharge; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000706:statistics & numerical data*; D017010:Reminder Systems