Computer-based vs manual health maintenance tracking. A controlled trial

Arch Fam Med. 1994 Jul;3(7):581-8. doi: 10.1001/archfami.3.7.581.


Objective: To compare computer-based with manual health maintenance tracking systems to determine whether (1) a computer-based system will result in better provider compliance with the practice health maintenance protocol, (2) the incremental cost of operating a computer-based vs a manual health maintenance tracking system differs, and (3) inactive patients will respond to health maintenance reminders.

Design: Two-year prospective, randomized, controlled trial.

Setting: Rural, multiple-office, nonprofit, fee-for-service family practice.

Patients: Adult members of families in which at least one member had been seen by the practice within the past 2 years.

Intervention: A computer-based health maintenance tracking system that generated annual provider and patient reminders for all patients regardless of appointment status compared with a manual flowchart-based tracking system in which patient reminders were triggered by provider request.

Outcome measures: Provider compliance with the health maintenance protocol determined by preintervention and postintervention chart audits, costs of computer-based tracking, and response of inactive patients to health maintenance reminders.

Results: Overall provider compliance with the health maintenance protocol increased 15 percentage points in the computer-based tracking group and four percentage points in the manual group. The computer-based tracking group had significantly higher provider compliance than the manual group for eight of 11 procedures. The computer-based tracking system cost 78 cents per patient per year to operate. It was not associated with increased office visits or patient billings.

Conclusions: Computer-based health maintenance tracking improved provider health maintenance compliance compared with a manual system. The finding that health maintenance compliance improved without a significant increase in patient visits or billings requires confirmation in other settings but suggests that considerable health maintenance can be incorporated into ongoing patient care.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care Information Systems / economics
  • Ambulatory Care Information Systems / standards*
  • Chi-Square Distribution
  • Computer Systems
  • Demography
  • Family Practice / organization & administration
  • Female
  • Humans
  • Male
  • Middle Aged
  • New York
  • Patient Compliance
  • Preventive Health Services / organization & administration*
  • Preventive Health Services / statistics & numerical data
  • Prospective Studies
  • Reminder Systems / economics
  • Reminder Systems / standards*