Coordination of Care and Its Relationship to Continuity and Medical Records

Introduction of a computerized printout ("mini record") containing problems and therapies, and listing visits between regularly scheduled ones to a primary care facility, resulted in improved recognition of problems and therapies. Recognition both of the occurrence of the visits which had been made elsewhere and the content of those visits was not improved, even though the mini record listed the dates and place of visit. Recognition was improved more in situations where the practitioners in the primary care clinic changed than when the practitioner remained the same individual who had seen the patient at the previous visit to the primary care clinic. Coordination of care is an essential ingredient of primary care. Recognition of all information generated by patients in a series of visits is evidence of coordination. Continuity (whether achieved by continuity of practitioner or by medical records) is one means of attaining better coordination. In a previous study we showed that continuity of practitioner improves coordination. This study shows that a technologic innovation consisting of an alteration in medical records facilitates coordination, but only with regard to certain aspects of care. Explanations for this finding are postulated.