An Electronic Linkage System for Health Behavior Counseling

Effect on Delivery of the 5A's

This article reports the findings of a feasibility evaluation examining the effects of an electronic linkage system (eLinkS) on health behavior counseling rates. The eLinkS facilitates the incorporation of the 5A’s—ask, advise, assess, assist and arrange—into the practice setting and creates an automatic patient referral system to community counseling projects. Addressing tobacco use, unhealthy diet, physical inactivity and risky alcohol use—behaviors contributing to rising rates and costs of chronic care—through referrals to intensive counseling may have significant public health benefits.

The eLinkS was implemented at nine primary care practices. Nine months of free counseling at a venue of their choice was offered to patients and included group counseling, telephone counseling, computer care and usual care. The evaluation examined the delivery of behavioral counseling and reported patient experiences with eLinkS. The counseling fund was depleted for the five weeks eLinkS was used due to the high referral volumes.

Contrasted with practice norms, the eLinkS increased the referral rate for intensive behavior counseling, providing an easy way for clinicians to assist their patients in receiving the help they need. Clinician and community collaboration may be important to chronic care management: harnessing technology will facilitate an easier collaboration.