Faculty of Medicine, University of New South Wales, Sydney 2052, Australia.
Int J Med Inform. 2010 Mar;79(3):167-72. doi: 10.1016/j.ijmedinf.2009.12.006. Epub 2010 Jan 25.
To examine the effectiveness of delivering of computer-generated discharge summaries to general practice by email, fax, post and patient hand delivery.
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.
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.
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).
Receipt of discharge summary by the general practice clinic within 7 days of patient discharge from hospital.
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.
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.
考察通过电子邮件、传真、邮寄和患者送达的方式将计算机生成的出院小结传递给全科医生的效果。
盲法、随机对照试验。在对全科医生进行出院沟通首选媒介的预研究审计和随访调查中，确定了基线统计数据。
196 名入住 300 床大都市教学医院老年护理病房的老年患者。28 名患者失访，52 家全科医生诊所参与了最终调查。预研究审计跟踪了同一病房的 63 次出院。
将 168 名符合条件的患者随机分配，通过电子邮件（n=40）、传真（n=48）、邮寄（n=40）或患者送达（n=40）接收电子出院小结。
患者出院后 7 天内，全科医生诊所收到出院小结的情况。
电子邮件（73.9%，n=17）和传真的接收率相当（69.4%，n=25；卡方=0.137，df=1，P=0.712），且显著高于邮寄（43.8%，n=14）和患者送达（24.2%，n=8）。全科医生表示，传真是沟通出院小结的最首选方法（82.7%）。大多数全科医生（75.0%）使用电子系统存储患者信息，而 88.5%的诊所报告使用医疗处方软件。
只要能获得准确的联系方式，通过传真或电子邮件传输计算机生成的出院小结是与初级保健医生进行沟通的最有效方法。虽然传真仍然是最受欢迎的，但电子邮件具有许多优势，有可能使其取代传真成为出院沟通的标准模式。
