Is email an effective method for hospital discharge communication? A randomized controlled trial to examine delivery of computer-generated discharge summaries by email, fax, post and patient hand delivery

摘要

Objective: To examine the effectiveness of delivering of computer-generated discharge summaries to general practice by email, fax, post and patient hand delivery. Design: Blinded, randomized controlled trial. A pre-study audit ascertaining baseline statistics and a follow-up survey were conducted with general practice to determine preferred medium for receiving discharge communication.rnParticipants and setting: 196 geriatric patients who were admitted to the aged care ward of a 300-bed metropolitan teaching hospital. Twenty-eight patients were lost to follow-up and 52 general practices participated in the final survey. The pre-study audit followed 63 discharges from the same ward.rnIntervention: 168 eligible patients were randomly assigned to have their electronic discharge summary sent by email (n = 40), fax (n = 48), post (n = 40) or patient hand delivery (n = 40). Main outcome measures: Receipt of discharge summary by the general practice clinic within 7 days of patient discharge from hospital.rnResults: The receipt rates for email (73.9%, n = 17) and fax were comparable (69.4%, n = 25; χ~2=0.137, df=l, P = 0.712), and significantly higher (χ~2 = 19.86, df=3, P<0.0002) than post (43.8%, n = 14) and patient hand delivery (24.2%, n = 8). General practices indicated that fax was the most preferred method (82.7%) for communication of discharge summaries. The majority of general practices (75.0%) utilized an electronic system for storage of patient information while 88.5% of practices reported using medical prescribing software. Conclusions: Transmission of computer-generated discharge summaries by fax or email offers the most effective method of communicating with primary care physicians, as long as accurate contact information is available. Although fax is still the most preferred, email has many advantages that could potentially allow it to replace fax as a standard mode for delivery of discharge communication.