Dialing for Health: Factors that impact telephonic contact rates in a community based primary care health outreach program

Background: The nationwide effort to promote electronic health record (EHR) adoption holds the promise of improving the care of patients with chronic conditions lost to follow-up. However, small practices may lack sufficient resources to identify and reach out to these patients. The NYC Panel Management program is a grant funded initiative where shared Prevention Specialists leverage EHR powered registries at participating primary care practices to contact at-risk patients.

Objective: Identify factors correlated with successful telephone contact among adult patients not receiving recommended follow-up care to more accurately estimate the impact of future outreach programs.

Method: Review 2,451 call logs generated at 19 primary care practices in underserved communities over six months.

Results: Overall, 26.5% of calls were answered by the patient or a family member and 31.8% went to voice mail. These rates varied by time of day, with the most success being achieved in the afternoon (29.8% answered), and the least in the morning (22.4%). Contact rates also varied by community, from 21.7% at primarily English speaking practices to an average of 34.1% at Russian, Spanish and Chinese speaking practices, reflecting fewer wrong numbers and unanswered calls (20.3% vs. 41.1% at English speaking practices). Altogether, 5.5% of patients called were deceased or had switched providers.

Conclusion: When designing an outreach program targeting patients with chronic conditions, organizers need to account for as many as 40% of the patients proving unreachable, and must adjust projections by community demographics. However, focusing calling on particular times of day can maximize successful contacts.