A simple system of letters and telephone calls using electronic medical records (EMRs) significantly improved adherence to endoscopic follow-up recommendations among persons due for a colonoscopy examination.
The study began with a review of 2,609 EMRs from colonoscopies performed 5 years earlier. A total of 830 persons due for a repeat surveillance colonoscopy examination were identified and assigned either to standard care (procedures scheduled by the primary care provider [PCP] or directly by the patient, with no standardized reminder system used) or to a newly developed follow-up system.
The new, EMR-based system is initiated when a provider orders a follow-up test. The system notifies the PCP 4 months before the procedure due date, and at the 3-month mark, the patient is sent a standard reminder letter. An identical letter is sent 1 month before the due date. If the due date passes with no procedure scheduled or completed, the system alerts administrative staff to call the patient.
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Within 6 months of the colonoscopy due date, 241 (44.7%) of patients in the intervention arm had scheduled or completed the procedure, compared with 66 (22.6%) in the control group.
“This work provides justification for the creation of reminder systems to improve patient adherence to medical recommendations,” concluded the investigators (Gastroenterology. 2011;140:1166-1173; http://download.journals.elsevierhealth.com/pdfs/journals/0016-5085/PIIS0016508511000072.pdf).
