患者就诊失约后，患者门户提醒信息对眼科再预约就诊的影响：一项随机临床试验。
Effect of a Patient Portal Reminder Message After No-Show on Appointment Reattendance in Ophthalmology: A Randomized Clinical Trial.
机构信息
From the Department of Ophthalmology (S.A., R.B., L.W., N.M., J.C., A.W.,), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; Cleveland Clinic (S.A.), Cole Eye Institute, Cleveland, Ohio, USA.
From the Department of Ophthalmology (S.A., R.B., L.W., N.M., J.C., A.W.,), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
出版信息
Am J Ophthalmol. 2024 Jul;263:93-98. doi: 10.1016/j.ajo.2024.02.026. Epub 2024 Feb 23.
PURPOSE
To assess the efficacy of electronic health record (EHR) messaging for re-engaging patients with ophthalmology care after a missed appointment.
DESIGN
Prospective, randomized clinical trial.
METHODS
The study setting was an academic ophthalmology department. The patient population comprised of return patients age 18 years or older with an appointment "no show," or missed appointment. Over 2 phases of recruitment, 362 patients with an active patient portal in the EHR were selected consecutively each business day. Patients were randomized using a web-based tool to receive a reminder to reschedule via a standard mailed letter only (control) or the mailed letter plus an electronic message through the EHR within 1 business day of the missed appointment (intervention). Reengagement with eye care was defined as attendance of a rescheduled appointment within 30 days of the no-show visit. Patient charts were reviewed for demographic and clinical data.
RESULTS
The average age of recruited patients was 59.9 years, just under half of the sample was male (42.5%, 154/362), and most patients were White (56.9%, 206/362) or Black (36.2%, 131/362). Patients were most commonly recruited from the retina service (39.2%, 142/362) followed by the glaucoma service (29.3%, 106/362). Many patients in this study had previous no-show appointments, with an average no-show rate of 18.8% out of all scheduled visits across our health system. In total, 22.2% (42/189) of patients in the intervention group attended a follow-up appointment within 30 days of their no-show visit compared to 11.6% (20/173) of the control group (OR, 2.186; 95% CI, 1.225-3.898; P = .008). When including only the 74 patients in the intervention group who read the intervention message in the patient portal, 28.4% (21/74) attended a follow-up compared to 11.6% (20/173) of the control group (P = .001).
CONCLUSIONS
EHR-based reminder messages sent within a business day of a missed appointment may promote re-engagement in ophthalmology care after appointment no-show.
目的
评估电子健康记录（EHR）信息在错过预约后重新参与眼科护理的疗效。
设计
前瞻性、随机临床试验。
方法
研究地点为一家学术眼科诊所。患者人群包括 18 岁及以上的返回患者，他们有预约“未到”或错过预约。在招募的两个阶段中，每天连续选择 EHR 中有活动患者门户的 362 名患者。患者使用基于网络的工具随机分配，仅接受标准邮寄信件提醒重新安排预约（对照组）或错过预约后 1 个工作日内通过 EHR 发送电子消息的邮寄信件加电子消息（干预组）。重新参与眼科护理的定义为在错过就诊后的 30 天内参加重新安排的预约。查看患者病历以获取人口统计学和临床数据。
结果
招募患者的平均年龄为 59.9 岁，样本中近一半为男性（42.5%，154/362），大多数患者为白人（56.9%，206/362）或黑人（36.2%，131/362）。该研究中大多数患者来自视网膜科（39.2%，142/362），其次是青光眼科（29.3%，106/362）。许多患者在此研究中有过之前的预约未到，在我们的医疗系统中，所有预约的平均未到率为 18.8%。总的来说，干预组中有 22.2%（42/189）的患者在错过就诊后的 30 天内参加了后续预约，而对照组为 11.6%（20/173）（OR，2.186；95%CI，1.225-3.898；P=.008）。当仅包括干预组中 74 名阅读患者门户中干预信息的患者时，28.4%（21/74）的患者参加了后续预约，而对照组为 11.6%（20/173）（P=.001）。
结论
错过预约后 1 个工作日内发送的基于 EHR 的提醒消息可能会促进错过预约后的眼科护理重新参与。
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