EMail Reminder to Follow up With Primary Physician

You Have Got Got Mail....and Need Follow Up

The purpose of this study is to see if patients who receive an email reinforcing their discharge instructions after being discharged from the emergency department will have an affect on follow-up care with their primary physician.

Study Overview

• Status: Completed
• Conditions: Act Code - Emergency
• Intervention / Treatment: Other: Email Reminder of need to follow up with primary physician

Detailed Description

When a patient is treated in the emergency department (ED), they experience a whirlwind of care involving multiple diagnostics and treatments. They are often discharged home with instructions to follow up with their primary care physician. This follow up care is crucial to ensuring optimal patient outcomes and re-establishing continuity of care. Despite efforts to communicate clearly and effectively, ED patients often have difficulty understanding their follow-up care instructions. Several different methods have been employed to attempt to improve the follow-up rates after emergency department care, including providing patients with an easily read, printed copy of discharge instructions, having a nurse or mid-level provider call patients days after discharge from the ED to ensure that they understood discharge instructions. One medium for communication that has become increasingly relevant in recent years is electronic mail (email). Because of its pervasiveness and relative ease of use, email offers a potentially valuable resource for augmenting and improving communication between physicians and patients. This study will assess whether an email reminder with follow up instructions one day after ED visit occurs will increase follow up rates and timely follow up rates.

• Study Type: Interventional
• Enrollment (Actual): 577
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 1. Patients triaged to category 2, 3, and 4 and placed in a room for care at St. Joseph Mercy Hospital-Ann Arbor Emergency Department 2. Primarily English speaking. 3. >18 years of age 4. Have a primary physician who is part of Integrated Health Associates 5. Have access to an email account

Exclusion Criteria:

• 1. Patients triaged to category 1 or 5 placed in a room at Stl Joseph Mercy Hospital-Ann Arbor (category 1 patients are not typically discharged home from the hospital. Category 5 patients could potentially be interfered with if attempting implementation of the communication instrument. Category 5 patients are typically very straightforward visits with minimal requirement for follow-up appointments) 2. Patients < age 18 3. Prisoners or institutionalized persons 4. Patients with a mental-health related chief complaint 5. Not primarily English speaking (the potential language barriers could interfere with ability to communicate via email which will be written in English) 6. Under temporary or permanent custodianship (used as a surrogate for ongoing lack of mental competence or consciousness) 7. Prior participation in this study. (A patient may only participate once).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Email Group; Includes receiving standard of care discharge instructions plus an email after being discharged home from the emergency department, reinforcing their discharge instructions. Included in the email is their physician's name and recommended timing of follow-up visit.	Other: Email Reminder of need to follow up with primary physician
No Intervention: Standard of Care; Includes standard of care discharge instructions after being discharged from the emergency department. This included receiving paper copies of their discharge instructions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Successful follow-up with primary care physician	Review of medical records at primary care physician's office by one of two physician investigators	10 days

Collaborators and Investigators

• Sponsor: Saint Joseph Mercy Health System

Study record dates

Study Major Dates

• Study Start: August 1, 2011
• Primary Completion (Actual): March 1, 2014
• Study Completion (Actual): March 1, 2014

Study Registration Dates

• First Submitted: October 23, 2014
• First Submitted That Met QC Criteria: October 23, 2014
• First Posted (Estimate): October 24, 2014

Study Record Updates

• Last Update Posted (Estimate): October 24, 2014
• Last Update Submitted That Met QC Criteria: October 23, 2014
• Last Verified: October 1, 2014

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: StJosephMHS