Following up on patients after they are discharged from a hospital's emergency department can be time consuming, complex, and costly.
However The Hospital for Sick Children in Toronto -- affectionately dubbed SickKids -- has found a tool to speed up, streamline and simplify that process: the Internet.
A recent SickKids study discovered that the Internet is a very effective mechanism for distributing Emergency Department test results. Results of the study were reported in the August issue of The Journal of Pediatrics -- a publication targeted at physicians who diagnose and treat disorders in infants, children and adolescents.
The driving force behind the SickKids study was a very real issue faced by the hospital: difficulty in transmitting vital medical information -- such as test results -- to guardians of recently discharged children.
Researchers at SickKids found that all too often, results -- of tests conducted in the hospital's emergency department, for instance -- were not available until days after a child was discharged. Emergency department staff, typically physicians, had to report results to the family by phone.
Frequently, this proved to be a hit-and-miss kind of exercise, according to Dr. Ran Goldman, the study's principal investigator. Goldman said emergency staff, often had difficulty connecting with some parents despite repeatedly calling them at home. Sometimes physicians were compelled to correspond with parents by "snail mail", a lengthy and tedious process.
In many instances, said Goldman, parents' awareness of test results is crucial to the treatment of the child's illness. "In some cases we need to tell the parents to start their children on antibiotics, and tell them to go and buy the antibiotics for their child."
There had to be a better way to do it than by phone or snail mail, he said.
To find that way, SickKids researchers recruited families of children who had cultures taken before discharge. Parents or guardians were given a unique user ID and password to retrieve information on culture results from the study's Web site. When the results were posted, an e-mail notification was sent to the family.
"We wanted to explore new ways of communicating with parents," Goldman said. "We knew 89 percent of our community had Internet access, and could (check results) any time of the day from any computer, print it, e-mail it, [and] send it to whoever they wanted."
Results of the study indicated that 61 percent of the caregivers accessed their ward's test results on the Internet-based system. 79 percent of the families of children with positive cultures looked up their results on the system.
"We found parents do not access the Web immediately," Goldman said. "To improve (response time), parents were told in advance when to expect the results to come in." He said -- to speed up the process -- parents also need to be informed about the importance of accessing their child's test results.
SickKids intends to conduct future studies to determine the cost effectiveness of a Web-based system as well as to determine how parents can play a more proactive role -- actively seeking out test results on the computer, instead of passively receiving them.
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