Int J Med Inform - Is email an effective method for hospital discharge communication? A randomized controlled trial to examine delivery of computer-generated discharge summaries by email, fax, post and patient hand delivery.

Tópicos

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Resumo

JECTIVE: To examine the effectiveness of delivering of computer-generated discharge summaries to general practice by email, fax, post and patient hand delivery.DESIGN: Blinded, randomized controlled trial. A pre-study audit ascertaining baseline statistics and a follow-up survey were conducted with general practice to determine preferred medium for receiving discharge communication.PARTICIPANTS AND SETTING: 196 geriatric patients who were admitted to the aged care ward of a 300-bed metropolitan teaching hospital. Twenty-eight patients were lost to follow-up and 52 general practices participated in the final survey. The pre-study audit followed 63 discharges from the same ward.INTERVENTION: 168 eligible patients were randomly assigned to have their electronic discharge summary sent by email (n=40), fax (n=48), post (n=40) or patient hand delivery (n=40).MAIN OUTCOME MEASURES: Receipt of discharge summary by the general practice clinic within 7 days of patient discharge from hospital.RESULTS: The receipt rates for email (73.9%, n=17) and fax were comparable (69.4%, n=25; chi(2)=0.137, df=1, P=0.712), and significantly higher (chi(2)=19.86, df=3, P<0.0002) than post (43.8%, n=14) and patient hand delivery (24.2%, n=8). General practices indicated that fax was the most preferred method (82.7%) for communication of discharge summaries. The majority of general practices (75.0%) utilized an electronic system for storage of patient information while 88.5% of practices reported using medical prescribing software.CONCLUSIONS: Transmission of computer-generated discharge summaries by fax or email offers the most effective method of communicating with primary care physicians, as long as accurate contact information is available. Although fax is still the most preferred, email has many advantages that could potentially allow it to replace fax as a standard mode for delivery of discharge communication.

Resumo Limpo

jectiv examin effect deliv computergener discharg summari general practic email fax post patient hand deliverydesign blind random control trial prestudi audit ascertain baselin statist followup survey conduct general practic determin prefer medium receiv discharg communicationparticip set geriatr patient admit age care ward bed metropolitan teach hospit twentyeight patient lost followup general practic particip final survey prestudi audit follow discharg wardintervent elig patient random assign electron discharg summari sent email n fax n post n patient hand deliveri nmain outcom measur receipt discharg summari general practic clinic within day patient discharg hospitalresult receipt rate email n fax compar n chi df p signific higher chi df p post n patient hand deliveri n general practic indic fax prefer method communic discharg summari major general practic util electron system storag patient inform practic report use medic prescrib softwareconclus transmiss computergener discharg summari fax email offer effect method communic primari care physician long accur contact inform avail although fax still prefer email mani advantag potenti allow replac fax standard mode deliveri discharg communic

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