Can the Doctor's Office Remind You? Computerized Follow-Up Among U.S. Physicians, 2017

Preventive and follow-up care can improve health, reduce disease and cut long-term costs, yet only about half of people in the United States get generally recommended preventive services, and missed appointments get in the way. Electronic reminders can help — for immunizations and cancer screening, for example — but only if the office has a computerized way to find the patients who are due.

The survey

• Data: the 2017 National Electronic Health Records Survey (NEHRS), a nationally representative survey of office-based physicians, sponsored by the Office of the National Coordinator for Health Information Technology and run by CDC's National Center for Health Statistics.
• Who: nonfederally employed physicians mainly in direct patient care, in the 50 states and DC; anesthesiologists, pathologists and radiologists excluded. Sample 10,302; weighted response rate 33.6%.
• The question: "Does the reporting location use a computerized system to identify patients due for preventive or follow-up care?" — software that flags who needs care and sends an alert or reminder. That is distinct from an electronic health record (EHR) system, which holds information from all of a patient's clinicians, though some EHRs include such reminders.

Results

64.7% of office-based physicians had the capability.

There were no differences by medical degree, sex, accepting new patients or metropolitan status.

After adjusting for all these characteristics together, only two differences remained:

• specialty: surgeons and other non-primary care physicians were less likely than primary care physicians to have it (adjusted prevalence ratio 0.8 for each);
• EHR use: physicians in practices with an EHR were about three times as likely to have it (2.9) — expected, since some EHRs include this function.

Limits

• Only nonfederal, office-based physicians were surveyed — not those in hospitals, prisons, Veterans Affairs facilities and other settings.
• The survey asked whether the capability existed, not whether it was used or worked.
• Some possibly relevant factors, such as years in practice or daily patient volume, weren't available.

The point: electronic reminders make patients more likely to come back for care, which improves health outcomes — but the office first has to be able to identify who is due, and having an EHR makes that more likely.

Sources

Based on Ogburn DF, Ward BW, Ward A, "Computerized Capability of Office-Based Physicians to Identify Patients Who Need Preventive or Follow-up Care — United States, 2017," MMWR Morbidity and Mortality Weekly Report, volume 69, Centers for Disease Control and Prevention; a work of the United States government in the public domain.