Bergmo Trine S, Kummervold Per Egil, Gammon Deede, Dahl Lauritz Bredrup
Norwegian Centre for Telemedicine, University Hospital of North Norway, N-9038 Tromsø, Norway.
Int J Med Inform. 2005 Sep;74(9):705-10. doi: 10.1016/j.ijmedinf.2005.06.002.
Electronic patient-provider communication promises to improve efficiency and effectiveness of clinical care. This study aims to explore whether a secure web-based messaging system is an effective way of providing patient care in general practices.
We conducted a randomised controlled trail and recruited 200 patients from the waiting area in one primary clinic in Norway. Participants were randomised to either the intervention group, which received access to a secure messaging system, or the control group receiving standard care without such access. Primary outcome measures were number of online consultations, telephone consultations and office visits in the two groups. Data were derived from patient records and collected 1 year prior to (baseline), and 1 year after the intervention.
Forty-six percent of the patients who were given access to the messaging system (n=99) used the online communication system on at least one occasion (ranging from 1 to 17 messages per patient per year). A total of 147 electronic messages were sent to six general practitioners during a 1-year trial period. Eleven percent of the messages were to schedule an appointment. In 10% of the messages, the GP was unable to respond adequately and recommended an office visit. The reduction in office visits over time was greater for the intervention group than for the control group (P=0.034). There was however no significant difference in the number of telephone consultations between the groups during the study (P=0.258).
The use of a secure electronic messaging system reduced the number of office visits at the general practice, but not phone consultations.
电子医患沟通有望提高临床护理的效率和效果。本研究旨在探讨基于网络的安全信息系统是否是在全科医疗中提供患者护理的有效方式。
我们进行了一项随机对照试验，从挪威一家初级诊所的候诊区招募了200名患者。参与者被随机分为干预组（可使用安全信息系统）或对照组（接受无此系统的标准护理）。主要结局指标是两组的在线咨询、电话咨询和门诊就诊次数。数据来自患者记录，在干预前1年（基线）和干预后1年收集。
有权使用信息系统的患者中，46%（n = 99）至少使用过一次在线通信系统（每位患者每年1至17条信息）。在为期1年的试验期内，共向6名全科医生发送了147条电子信息。11%的信息是预约就诊。在10%的信息中，全科医生无法充分回复并建议门诊就诊。随着时间的推移，干预组门诊就诊次数的减少幅度大于对照组（P = 0.034）。然而，研究期间两组之间的电话咨询次数没有显著差异（P = 0.258）。
使用安全的电子信息系统减少了全科医疗中的门诊就诊次数，但未减少电话咨询次数。
