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AHRQ-funded computer-based patient tracking software served as the model for the development of a more complex patient tracking system used at various times by primary care clinics in 13 states and Beijing, China.

HTRAK, the computer-based tracking system developed with ÂÜÀòÊÓƵfunding, was created by Paul Frame, MD. Using Frame's system as a model, Bruce Block, MD, Director, Primary Care Institute, University of Pittsburgh Medical Center, designed his own patient tracking software called Health Status Tracker (HS Tracker).

Says Block, "Dr. Frame's work laid the groundwork for all patient reminder systems. I was influenced greatly by his work and by his generous mentorship." Block developed and implemented HS Tracker while at the University of Pittsburgh School of Medicine's Family Health Center, which serves diverse populations in the Pittsburgh community.

Both HTRAK and HS Tracker are examples of automated patient tracking systems. They differ from computerized patient record systems in that they are much cheaper and easier to set up than the more comprehensive computerized patient record systems. The stand-alone systems can run on a single computer, minimize duplication of data entry, help deliver preventive services, help manage care for patients with chronic conditions, and help meet health plans' information demands.

At East Liberty Family Health Care Center, an inner-city clinic serving many low-income and Medicaid patients in Pittsburgh, a computer equipped with Block's HS Tracker was used to store immunization histories of the clinic's pediatric patients. The computer program provided reminders to parents and physicians whenever vaccines were due or lacking for children coming in for either well-child or acute-care visits. A printed one-page immunization record provided the child's complete immunization record and noted any that were overdue. The computer software also identified patients to be notified about overdue immunizations.

At the East End Community Health Center in Pittsburgh, the system was implemented to simplify documentation of health maintenance and to remind physicians and patients when actions are overdue. The system increased insight into the complex process of health promotion as an important clinical, education, and research tool.

In addition to Pennsylvania, HS Tracker has been used by primary care clinics in Alabama, Alaska, Colorado, Connecticut, Florida, Maine, Michigan, Nevada, New York, Texas, West Virginia, and Wisconsin.

Data supports the efficacy of this tool. According to Richard Zimmerman, MD, MPH, Professor, University of Pittsburgh Department of Family Medicine, immunization rates for diphtheria, pertussis, and tetanus (or DPT #3) by three months of age were 74 percent before the implementation of the computer software and 84 percent afterwards. For Haemophilus influenzae type b, a common bacteria that causes a wide variety of infections in children, the rates were 52 percent before and 81 percent afterward.