20 Follow-Up after a Paediatric Emergency Department Visit – Telephone versus Electronic Mail

Abstract

The Internet has become an unlimited source of health related information and revolutionised health information access by parents. Follow-up after an Emergency Department (ED) visit is important for continuity of care, monitoring changes in patient health and for informing patients of test results taken during their visit. We conducted this study to determine if electronic main (e-mail) would be better than phone for follow-up. During two months, research assistants recruited parents of children being discharged from a large tertiary ED in Toronto, Ontario, that have a personal e-mail account and a personal telephone line. Parents were randomized to e-mail or phone follow-up, that included two questions. Parents not replying to the e-mail were contacted via telephone after 10 days. The main outcome measure was the response rate. Data was collected on Microsoft Excel and statistical analyses used SPSS for calculation of response rate and comparisons between the phone and e-mail groups. A total of 337 families were approached. Two hundred and sixty five (79%) had Internet access, personal e-mail and telephone line available and 75% of them check e-mails at least once a day. A total of 198 families were randomized for a follow-up. Of 98 families, 85 (87%) were reached by phone within average of 17 hours (range 0–98). Of 100 families contacted via e-mail only 53 (53%) responded in a mean of 46 hours (range 0–242) (p<0.0005). Ten (10%) of the e-mails “bounced back”. Of the parents in the e-mail group that had received the e-mail and did not respond 21 (57%) did not check the e-mail, did not remember reading the e-mail or had problems with e-mail access, 1 (3%) did not have time to respond and 15 (40%) were not reached even by phone. E-mail failed to be better than phone in reaching families for follow-up after a Paediatric ED visit. It could be used for non-urgent messages by about half of our patient population that can access the Internet.