Table 1

Characteristics of studies included in review by study design

Study: authors, country (year)DesignSetting/patientsIntervention groupControl group
  • Afilalo et al, Canada (2007)6;

  • Lang et al, Canada (2006)7

RCT (4-period cluster crossover)ED
  • n=23 (PCPs)

  • 1048 patient visits to ED

  • Two 10-week periods

  • PCPs received a secure, web-based communication system including ED notes, as consultant notes, laboratory results, ECG, imaging reports, discharge planning, medication changes

  • Daily/immediate advisory emails alerting PCP of ED visit

  • n=Same 23 (PCPs)

  • 974 patient visits to ED

  • Two 10-week periods

  • PCPs received usual posted copies of the ED notes (1–2 weeks postdischarge)

García-Aymerich et al, Spain (2007)17RCTChronic obstructive pulmonary disease patients: Respiratory and Environmental Health Research Unit
  • n=44

Four key features:
  • Comprehensive assessment of the patient at discharge

  • Educational programme on self-management

  • Individually tailored care plan shared across the system via interaction between nurse care manager and the primary care team

  • Information and communication technologies platform including web-based call centre containing discharge information

  • n=69

  • Patients received pharmacological prescriptions and in-hospital treatment

  • Standard protocols of centres involved (no help from specialised nurse, no educational programme, no access to the call centre)

Casas et al, Spain, Belgium (2006)16RCTChronic obstructive pulmonary disease patients: Respiratory and Environmental Health Research Unit
  • n=65

Four key features:
  • Comprehensive assessment of the patient at discharge

  • Educational programme on self-management

  • Individually tailored care plan shared across the system via interaction between nurse care manager and the primary care team

  • Information and communication technologies platform including web-based call centre containing discharge information

  • n=90

  • Patients received pharmacological prescriptions and in-hospital treatment

  • Followed standard protocols of centres involved (no help from specialised nurse, no educational programme, no access to the call centre)

Gray et al, USA (2000)18RCTInfants in neonatal intensive care unit
  • n=26

  • Families accessed Baby CareLink, a multifaceted telemedicine program (videoconferencing and internet technology).

  • Six areas of clinical content were available: a daily clinical report, message centre, infant photos, family room, clinical information, individualised preparation for discharge

  • n=30

  • Usual care (no access to Baby CareLink)

van Walraven and Rokosh, Canada (1999)19RCTGeneral internal medicine patients
  • n=184

  • Database created DS, posted/faxed

  • n=187

  • Dictated DS, posted/faxed

Maslove et al, Canada (2009)13RCT (Cluster)513-bed tertiary care hospital, General Internal Medicine Service
  • n=56 surveys, 46 DS, 50 patient phone interviews

  • EDS created by text fee-entry, pasting from hospital IT system, pick lists

  • n=63 surveys 48 DS, 54 patient phone interviews

  • Traditional dictated DS (mailed/faxed to outpatient physicians)

Graumlich et al, USA (2009)10 11RCT (Cluster)730-bed, tertiary care hospital, General Internal Medicine Service
  • n=34 physician clusters, 316 patients

  • Computerised physician order entry system/EDS including decision support. Output of four documents: personalised PCP letter, prescription list, patient instructions, discharge orders by fax/post.

  • n=35 physician clusters, 315 patients

  • Traditional handwritten DS

Kirby et al, UK (2006)12Prospective Intervention (Concurrent Control)Department of Diabetes and Endocrinology
  • n=50

  • New EDS integrated with electronic discharge prescriptions

  • n=52

  • Conventional discharge system (conventional discharge prescriptions and dictated discharge summaries, posted/faxed)

Branger et al, Netherlands (1992)15Before–after27 PCPs, two regional hospitals, unspecified services
  • n=27 PCPs, 1388 (admission-discharge reports, 1396 laboratory results)

  • Electronically transmitted messages (admission and discharge reports, laboratory reports, free text)

  • n=NA

  • Traditional paper-based communication, posted/faxed

  • Callen et al, Australia (2008)8;

  • Callen et al, Australia (2010)9

Before–afterMedical and rehabilitation patients, 78-bed public hospital
  • n=151

  • EDS integrated with electronic discharge prescriptions, posted to PCP

  • n=94

  • Handwritten DS posted

O’Leary et al, USA (2009)14Before–afterGeneral medical patients admitted to a 753-bed hospital
  • n=95

  • EDS generated by electronic medical record

  • Automatic insertion of data, automatic fax to outpatient physicians

  • n=101

  • Traditional dictated DS (mailed/faxed to outpatient physicians)

  • DS, discharge summary; ED, Emergency Department; EDS, electronic discharge summary; PCP, primary care physician/outpatient physician; RCT, randomised controlled trial.