TY -的AU -霍法,莫妮卡AU -利维,珍妮特盟- L·恩格尔,皮特AU -卡尔森,博伊德盟-艾哈迈德阿西夫盟——Ferranti Jeffrey PY - 2011 DA - 2011/05/26 TI -健康门户注册电子邮件提醒对依从性的影响诊所预约:一个试点研究乔- J地中海互联网Res SP -出价六世- 13 - 2 KW -提醒系统千瓦健康信息技术经济和临床卫生法案KW -医学信息学应用AB -背景:提供对部分电子健康记录的访问的互联网门户技术有可能彻底改变患者对其护理的参与。然而，关于门户网站注册者的人口统计特征或门户网站技术对质量结果的影响的描述相对较少。这项研究检查了从七个杜克医学诊所之一就诊的患者的数据，这些患者可以选择注册并使用杜克医学健康视图门户(HVP)。HVP允许患者管理他们预约安排的细节，除了所有患者收到的电话和邮件提醒外，还提供自动的电子邮件预约提醒。目的:我们的目的是测试具有电子邮件提醒功能的门户注册是否与预约“未到”率的降低显著相关，而预约“未到”率已知会损害诊所的运营效率。方法:在1年的时间里，对所有在杜克医学7个诊所就诊的患者进行检查。根据患者在预约时或1年期结束时的状态，将患者分为门户网站注册者和非用户。比较了这些组的人口学特征和缺勤率。建立二项logistic回归模型来衡量HVP入组对缺勤率的调整影响，考虑混杂因素。 To demonstrate the effect of HVP use over time, monthly no-show rates were calculated for patient appointment keeping and contrasted between preportal and postportal deployment periods. Results: Across seven clinics, 58,942 patients, 15.7% (9239/58,942) of whom were portal enrollees, scheduled 198,199 appointments with an overall no-show rate of 9.9% (19,668/198,199). We found that HVP enrollees were significantly more likely to be female, white, and privately insured compared with nonusers. Bivariate no-show rate differences between portal enrollment groups varied widely according to patient- and appointment-level attributes. Large reductions in no-show rates were seen among historically disadvantaged groups: Medicaid holders (OR = 2.04 for nonuser/enrollee, 5.6% difference, P < .001), uninsured patients (OR = 2.60, 12.8% difference, P < .001), and black patients (OR = 2.13, 8.0% difference, P < .001). After fitting a binomial logistic regression model for the outcome of appointment arrival, the adjusted odds of arrival increased 39.0% for portal enrollees relative to nonusers (OR = 1.39, 95% CI 1.22 - 1.57, P < .001). Analysis of monthly no-show rates over 2 years demonstrated that patients who registered for portal access and received three reminders of upcoming appointments (email, phone, and mail) had a 2.0% no-show rate reduction (P < .001), whereas patients who did not enroll and only received traditional phone and mail reminders saw no such reduction (P < .09). Conclusions: Monthly no-show rates across all seven Duke Medicine clinics were significantly reduced among patients who registered for portal use, suggesting that in combination with an email reminder feature, this technology may have an important and beneficial effect on clinic operations. SN - 1438-8871 UR - //www.mybigtv.com/2011/2/e41/ UR - https://doi.org/10.2196/jmir.1702 UR - http://www.ncbi.nlm.nih.gov/pubmed/21616784 DO - 10.2196/jmir.1702 ID - info:doi/10.2196/jmir.1702 ER -