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Improving Disease Reporting by Clinicians: The Effect of an InternetBased Intervention

Ward, Lawrence D. MD, MPH, FACP; Spain, C. Victor PhD, DVM; Perilla, Mindy J. MPH; Morales, Knashawn H. ScD; Linkin, Darren R. MD, MSCE

Journal of Public Health Management & Practice:
doi: 10.1097/01.PHH.0000303414.19851.d9
Article
Abstract

Objectives: Disease surveillance by clinicians is critical to public health activities, yet studies have demonstrated significant underreporting of reportable diseases by clinicians. We sought to determine whether an intervention utilizing electronic media increases public health reporting by clinicians.

Methods: A nonrandomized, controlled design with 24-week baseline and intervention outcome periods was used. Five intervention hospitals in the county of Philadelphia received a three-component intervention that included e-mail memoranda, a Web site, and a handheld computer program. Intervention components provided education and information to assist with reporting. Control hospitals comprised all remaining hospitals in the county.

Results: E-mails were sent to more than 16500 clinicians and administrative personnel at five hospitals on each of three occasions. The Web site received 866 visits, and the handheld computer program was downloaded 130 times. Intervention hospitals had a mean increase of 5.6 reports, whereas control hospitals had a mean decrease of 3.0 reports (P = .02).

Conclusions: The electronic information–based intervention led to a significant increase in clinician reporting of reportable diseases. Considering the ease and low cost of implementing such programs, they are an attractive method for increasing clinician reporting of public health conditions.

In Brief

This article demonstrates the effect of an Internet-based intervention for improving disease reporting by clinicians. The ease and low cost of implementation of such programs make them an attractive method for increasing clinician reporting.

Author Information

Lawrence D. Ward, MD, MPH, FACP, is with Section of General Internal Medicine, Department of Medicine, Temple University, Philadelphia, Pennsylvania.

C. Victor Spain, PhD, DVM, is with Philadelphia Department of Public Health, Philadelphia, Pennsylvania.

Mindy J. Perilla, MPH, is with Philadelphia Department of Public Health, Philadelphia, Pennsylvania.

Knashawn H. Morales, ScD, is with Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.

Darren R. Linkin, MD, MSCE, is with Division of Infectious Diseases, Department of Medicine, and Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania; and Philadelphia VA Medical Center, Philadelphia, Pennsylvania.

Corresponding Author: Lawrence D. Ward, MD, MPH, FACP, Temple University, 3401 North Broad St, 4th Floor, Outpatient Bldg, Philadelphia, PA 19140 (Lawrence.ward@tuhs.temple.edu).

The authors thank Neil O. Fishman, MD, Ebbing Lautenbach, MD, MPH, MSCE, of the University of Pennsylvania, and Keith St. John, MD, and Susan Coffin, MD, of Children's Hospital of Philadelphia, for their contribution to the conception of the study. We also thank Michael J. Ward for the development of the Internet Web site and handheld computer program, as well as Mark Weiner, MD, and Alice Livshits, MS, of the University of Pennsylvania, for extracting and analyzing ICD-9 administrative data. The Mentored Patient Oriented Research Career Development Award (K23-AI-060887-01) of the National Institutes of Health from the National Institute of Allergy and Infectious Diseases (D.R.L.) also supported this work. The institutional review boards of the University of Pennsylvania, the Philadelphia VA Medical Center, Children's Hospital of Philadelphia, and the Philadelphia Department of Public Health approved the study.

© 2008 Lippincott Williams & Wilkins, Inc.