PATIENT CARE REMINDER MODULES DEMONSTRATION PROJECT

将设计计算机化的患者护理提醒，其影响和 在一家大型独立的门诊医疗中心进行了成本测试。 将测试有关异常跟踪的两项任务的提醒 实验室检测结果，以及一项关于提示进行健康检查的任务 维修检查。具体目标是开发计算机化的提醒 用于公共使用的COSTAR模块；编制程序手册 计算机化提醒模块的开发.测量和描述 执行这些模块的困难；评估 电脑提醒对病人护理依从性的效果 协议、服务使用和医疗收益；以及评估 开发、实施和运行计算机化提醒 模块。 为进行评价，提出了一项随机对照试验。其中之一 检测任务(随访淋病阳性检测)，患者将 随机分配到提醒组或对照组(N=96)。对于另一种 两项任务(低血球压积的随访，N=230，以及在 女性，N=96)六个医疗助理单位中的三个将被随机分配 提醒其中一个任务的状态，而其他三个任务将在 其他任务的提醒状态。每个医疗助理单位都会在 未处于提醒状态的任务的控制状态。 根据状态，患者将处于提醒和控制状态 为他们提供服务的医疗助理单位。 关于遵守提醒以及服务使用和收益的数据将是 从医疗记录中收集的。关于提醒使用的数据将是 从计算机文件中收集所有提醒交易。详细 模块的开发和运营成本分析将基于 所使用的人员时间、物资供应和实物资源，以及 电脑成本。 分析从业者遵守协议、服务使用、 而医疗产量将使用Logistic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.