A computerized recall system for office practice.

A computerized system that has been in use in a small group practice since 1980 is described. Although many pediatricians have begun to use personal computers in office practice, most accounts of their experience to date relate primarily to the role of computers in facilitating administrative tasks, such as billing. The procedures involved in establishing the system are described, along with details about the nature of the programming concepts and several of the most important applications. A particular focus was to enable the computer to be used to improve the follow-up of patients with problems requiring recall visits, eg, immunizations. The results indicate that the percent of patients judged to be overdue for immunizations fell from 15.4% prior to the introduction of the computer to 1.3% and 4.3%, respectively, in the following 2 years. The proportion of children with other health problems requiring follow-up, 44.5% of the entire active practice population are also described. It is concluded that the computerized system can enhance the quality of patient care and greatly facilitate office-based research.

The organization and evaluation of a computer-assisted, centralized immunization registry.

The rationale for, and establishment of, a computer-assisted, centralized immunization registry are described. This registry was created to improve the quality and quantity of information regarding immunization status for a defined population receiving primary care from a variety of providers, principally public clinics and private practitioners. An evaluation of the feasibility of the registry after one year's function shows that 93 per cent of eligible providers initially agreed to participate and 73 per cent continue to do so. Their reports have resulted in the creation of 17,500 individual patient files. Of a prospective cohort of newborns, 23 per cent were identified as "high-risk" for overdue immunizations. After one year, the immunization rates in audited groups improved significantly. The direct cost of this registry is less than 65 cents per currently registered child per year.