[Computer communication between an ambulatory centre and its hospital of reference]

To analyse the demand for medical information requested by a primary care team from its hospital of reference over an 18 month period.

Patients assigned to 5 surgeries of a primary care team, which had computerised clinical records available in its hospital of reference. In 1995 computerised communication via modem was set up between this team and the "Local Area Network" of its hospital of reference. This connection allows members of the team to carry out real time consultations of the hospital clinical records of their patients (reports, complementary explorations...) and the laboratory and radiology reports requested by the primary care team. Consultations made over an 18 month period (March 96 - August 97) were analysed.

Five hundred and twenty three consultations were made (29.06 per month). Ninety three point seven per cent of the patients concerning whom consultations were made had a computerised clinical record available. The most consulted services were: Radiology (28.7%), Laboratory (25.2%) and Internal Medicine (16.3%). The most consulted parts of the clinical record were those corresponding to the results of complementary tests: simple radiology (27.3%), haematology and biochemistry (24.7%), other explorations (23.7%). Some 67.5% of the searches were considered "resolutive" by the consulting doctor. An average of 4 minutes 13 seconds were employed per consultation.

The information principally required by the family doctor was the results of complementary tests and, in particular, from the laboratory and radiology. Computerised communication between primary care and specialised care is going to be an effective, and probably efficient, system for improving communication between the two levels.