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Evid Based Nurs 1:58 doi:10.1136/ebn.1.2.58
  • Quality improvement

Review: telephone and computer communication improves healthcare process and patient outcomes

Efficacy of distance healthcare technologies

Intervention, number of studies, and results Improvements in process or patient care
Computerised communications 7 studies—all showed improvement in process, patient care, or both Improved glycohaemoglobin concentrations, dietetic knowledge and habits, and metabolic balance in patients with diabetes; improved decision confidence in caregivers of patients with Alzheimer's disease; reduction in ambulatory visits by college students
Telephone follow up and counselling 20 of 37 studies showed improvement in process, patient care, or both Increased compliance with follow up instructions; higher patient satisfaction; fewer unkept appointments; reduced inappropriate follow up care in the emergency department; improved smoking cessation rates, low density lipoprotein cholesterol concentrations; functional capacity; reduced emergency room visits; increased knowledge; decreased depression and anxiety; more rapid recovery of normal activity levels among cardiac patients; increased mammography and colposcopic examination rates; improved pain management for osteoarthritis; therapy for panic disorder; antituberculosis chemoprophylaxis treatment; dental screening programme; and tobacco use prevention
Telephone reminder 14 of 23 studies showed improvement in process, patient care, or both Improved appointment keeping, compliance with influenza vaccinations and medications, childhood immunisation; improved compliance with foot care instructions and behavioural interventions among patients with type II diabetes; decreased physical disability and pain in osteoarthritis
Interactive telephone systems 5 studies of 6 showed improvement in process, patient care, or both Increased influenza vaccination and medication compliance in elderly; increased knowledge about Alzheimer's disease; improvement in number and timing of childhood immunisation visits; decreased alcohol consumption in patients with drinking problems
After hours telephone access 3 studies of 4 showed improvement in process, patient care, or both Reduced hospital days, nursing home days, and outpatient visits; higher caregiver satisfaction for chronically or terminally ill patients; increased attendance at health maintenance visits, seeking of clinic care, and telephone contact attempts with clinicians by postpartum mothers
Telephone screening 1 study of 3 showed improvement in process Reliable collection of clinical and administrative data from broad geographic patient population

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