After the Grant Runs Out: Long-term Provider Health Maintenance Compliance Using a Computer-Based Tracking System

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Abstract
To measure long-term provider (physicians and physician's assistants) health maintenance compliance 4 years after the completion of a grant-funded project to improve provider compliance by using a computer-based health maintenance tracking system. Cross-sectional comparison of provider health maintenance compliance for patients receiving computer-based health maintenance tracking in 1992 and 1996. Rural, multiple-office, nonprofit, fee-for-service family practice. 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. Overall provider compliance was 83% in 1996, compared with 80% in 1992. This difference was statistically significant (P = .05) but not clinically significant. Provider compliance was significantly higher in 1996 for 3 procedures: blood pressure determination, tetanus-diphtheria immunization, and weight. It was unchanged for 5 procedures: clinical breast examination, mammography, Papanicolaou smears, cholesterol determination, and fecal occult blood testing for colon cancer. Provider compliance with obtaining a history of tobacco use declined. Improvements in provider health maintenance compliance associated with installation of a computer-based health maintenance tracking system were maintained 4 years after cessation of the formal research intervention.

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