ga

Skip to content

My Files [0]

These are the files you have added to your collection.

  • You don't have any documents yet, feel free to browse the website and add documents.

CADTH » Search All Products » Environmental Scanning » Health Technology Update » Issue 5, January 2007 » Interactive Voice Response System Helps Bridge Continuity of Care Between Hospital and Home

Interactive Voice Response System Helps Bridge Continuity of Care Between Hospital and Home

hta_update_interactive-voice.jpg

The Interactive Voice Response (IVR) process.

Photo composition by Matt Kulka (CADTH) and TelASK Technologies Inc.

A telephone follow-up program allows doctors to closely monitor patient recovery after hospital discharge. The automated calls use an Interactive Voice Response (IVR) system to ask personalized questions, and speech recognition technology to monitor responses.

How it Works

The IVR system calls the patients at home, early in their recovery phase, to ask a sequence of questions that screens for problems, such as inadequate pain control or shortness of breath. Patients respond with natural speech and, depending on their answers, subsequent questions may branch into several new series.

If a particular response – or combination of responses – suggests a serious problem, the call is transferred directly to a clinician at the hospital. Patients reporting minor symptoms receive a callback from a clinician within one day. Responses are electronically recorded in a database and clinicians can view results online or print data that are tabulated in various formats.

Algorithm

In each proprietary IVR algorithm (step-by-step procedure), questions are placed in a sequence that mimics a conversational interaction, with branching determined by specific responses. Voice professionals record the questions and the algorithm is tested in patient focus groups.

Algorithms can be customized to provide follow-up for patients for many health interventions, ranging from diabetes management to smoking cessation.

Potential Benefits

IVR increases clinician efficiency by monitoring the post-discharge progress of all patients and separating out those who need to speak to a clinician in person. Prompt intervention during recovery at home can avoid re-admission to hospital.

Studies have shown that patients may be willing to disclose more sensitive information, such as compliance with medication or alcohol use, during an IVR call compared to speaking with a human interviewer.[1]

IVR in Canada

Although telephone interviews with IVR systems were developed several years ago, their application in health care is relatively new in Canada. Several IVR systems have been developed by Ottawa-based TelASK Technologies Inc., in collaboration with the University of Ottawa Heart Institute.

Preliminary Evidence

An unpublished, randomized controlled feasibility study, conducted at the Ottawa Heart Institute, reported the results of IVR follow-up to support smoking cessation after patients were hospitalized for coronary heart disease. Smoking abstinence in the control group was 34.7% (17 of 49 patients) compared with 46.0% (23 of 50) in the patients who received IVR follow-up calls after discharge on days three, 14, and 30.

At the October 2006 Canadian Cardiovascular Congress, an Ottawa Heart Institute researcher reported that IVR follow-up was effective in the early identification of serious complications developing among 1,116 patients recovering at home following cardiac surgery.

Cost

According to TelASK, developing an IVR application costs from C$35,000 to C$50,000, depending on the complexity of the algorithm and the reporting required. Ongoing charges of up to C$20 per patient cover the costs of placing the calls, hosting the system in a secure Internet data centre, and providing training and support to hospital staff.

References

[1] Fewer bells and whistles, but IVR (interactive voice response) gets the job done. Dis Manag Advis 2001;7(9):129-33.