Home and Community Care Digest
Methods: The information technology department of the hospital developed a separate; secure web application that displayed the lab results for the study participants. For the purposes of the study, the web application (and server) was not connected directly to the main hospital computer system. In addition to the actual lab results, the following information was posted: culture type, interpretation of the culture results, the organism identified, and a telephone number to call if the parent(s) of the patient had any questions. An email was sent to the parent(s) notifying them that their child's lab result was available for viewing. When a "positive" result was posted, parents were informed that they would receive a telephone call from the ED physician.
The research assistant conducted follow-up telephone interviews with all parents five days after the results were posted on the website. Parents were asked about their experience and satisfaction using the system; if the results were shared with their family physician/pediatrician; if they printed the results; and whether the child's treatment was changed on the basis of the results. If parents did not access the system within the first five days, they were asked for the reasons why they did not. A follow-up telephone call was made to families who had previously not accessed the system or who were not reached during the first follow-up. The second follow-up was performed ten days after results were posted.
Findings: Out of a possible 527 families approached, a total of 303 families participated in the study. Of the 303 lab results posted on the web application, approximately 10% were positive. A total of 186 parents (61%) accessed the website to view their child's lab results, however only 43% of parents accessed the system within the first five days following the posting of the results. Forty-eight families visited the website before lab results were available, and six of these families did not return after the results were posted. 141 families were reached for a follow-up call, 16% of which printed the information, 26% reported the results to their family physician or pediatrician, and 5% had their child's treatment changed based on the lab results.
Conclusions: The Internet can be used to simplify the process of follow-up with families because it is available at all times, can be accessed from computers in a variety of places, can send information rapidly, and is relatively inexpensive once the infrastructure is in place. Making lab results available to patients over the Internet can potentially promote continuity of care in several ways. Patients or their families can retrieve information on culture tests at any time; results can be printed for personal records and shared with other health professionals providing care. In an age where increasing amounts of health care information is being made available on the Internet, this system can be used as a means to educate (e.g., how to interpret lab results) and can act as a catalyst to encourage patients to become more active in understanding and managing their care. Providing simple, user-friendly technological solutions to patients could be a cost-effective healthcare strategy in the long-term.
Reference: Goldman RD, Antoon R, Tait G, Zimmer D, Viegas A, Mountstephen B. "Culture results via the Internet: A novel way for communication after an emergency department visit". The Journal of Pediatrics, 2005; 147, 221-226.
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