After the grant runs out - Long-term provider health maintenance compliance using a computer-based tracking system

Objective: To measure long-term provider (physicians and physician's assist ants) health maintenance compliance 4 years after the completion of a grant -funded project to improve provider compliance by using a computer-based he alth maintenance tracking system. Design: Cross-sectional comparison of provider health maintenance complianc e for patients receiving computer-based health maintenance tracking in 1992 and 1996. Setting: Rural, multiple-office, nonprofit, fee-for-service family practice . Patients: Adults who had been seen by the practice in the past 2 years. Main Outcome Measures: Overall provider compliance with the common elements of the health maintenance protocols in 1992 and 1996. Provider compliance with specific, individual preventive interventions was compared. Results: Overall provider compliance was 83% in 1996, compared with 80% in 1992. This difference was statistically significant (P = .05) but not clini cally significant. Provider compliance was significantly higher in 1996 for 3 procedures: blood pressure determination, tetanus-diphtheria immunizatio n, and weight. It was unchanged for 5 procedures: clinical breast examinati on, mammography, Papanicolaou smears, cholesterol determination, and fecal occult blood testing for colon cancer. Provider compliance with obtaining a history of tobacco use declined. Conclusion: Improvements in provider health maintenance compliance associat ed with installation of a computer-based health maintenance tracking system were maintained 4 years after cessation of the formal research interventio n.