PATIENT CARE REMINDER MODULES DEMONSTRATION PROJECT

将设计计算机化的患者护理提醒，并评估其影响， 在一个大型独立的流动医疗保健中心进行了成本测试。 将针对两项关于异常事件随访的任务测试提醒 实验室测试结果，以及一项关于提示执行健康检查的任务 维护检查。 具体目标是开发计算机化提醒 供公众使用的COSTAR模块;编写 开发计算机化提醒模块;衡量和描述 实施这些单元的困难;评价 电脑化提醒对病人护理依从性的有效性 协议，服务使用和医疗收益;并评估 计算机提醒的开发、实施和操作 模块。 为了评价，建议进行随机对照试验。 一 测试任务（淋病阳性测试的随访），患者将 随机分配到提醒组或对照组（N=96）。 对于其他 两项任务（低血细胞比容随访，N=230， 女性，N=96）将随机分配6个医疗助理单位中的3个 其中一项任务的提醒状态，而其他三项任务将处于 其他任务的提醒状态。 每个医疗助理单位将在 不处于提醒状态的任务的控制状态。 根据状态，患者将处于提醒与对照状态 他们所服务的医疗助理单位。 将提供有关遵守提醒的情况、服务使用情况和收益的数据， 从医疗记录中收集的。 关于使用提醒的数据将 从所有提醒交易的计算机文件中收集。 详细 对模块开发和运行成本的分析将基于 所用的人力时间、物资供应和实物资源，以及 计算机成本。 分析从业者对方案的依从性、服务使用、 和医疗收益将使用逻辑回归模型来完成。

Computerized patient care reminders will be designed and their impact and cost tested in a large free-standing ambulatory health care center. Reminders will be tested for two tasks concerning follow-up of abnormal laboratory test results, and one task concerning prompts to perform health maintenance checks. Specific aims are to develop computerized reminder modules for public-use COSTAR; to produce a manual of procedures for the development of computerized reminder modules; to measure and describe difficulties in implementation of the modules; to evaluate the effectiveness of computerized reminders on compliance with patient care protocols, service use, and medical yield; and to assess the costs of the development, implementation, and operation of the computerized reminder modules. For the evaluation, a randomized controlled trial is proposed. For one test task (follow-up of positive tests from gonorrhea), patients will be randomly assigned to the reminder or control group (N=96). For the other two tasks (follow-up of low hematocrits, N=230, and cancer screening in women, N=96) three of six medical assistant units will be randomly assigned to reminder status for one of the tasks, while the other three will be in reminder status for the other task. Each medical assistant unit will be in control status for the task for which they are not in reminder status. Patients will be in reminder versus control status according to the status of the medical assistant unit by which they are served. Data on compliance with reminders, and on service use and yield, will be gathered from medical records. Data on the use made of reminders will be gathered from a computer file of all reminder transactions. Detailed analysis of development and operating costs of the modules will be based on personenel time, material supplies and physical resources used, and computer costs. Analysis of changes in practitioner compliance with protocols, service use, and medical yield will be accomplished using logistic regression models.