Interactive Voice Response in Disease Management: Providing Patient Outreach and Improving Outcomes

Interactive voice response (IVR) phone systems offer unique opportunities for disease management. This technology can address challenges in patient care, including how to provide personalised assessment and intervention to large populations in a cost efficient manner. Furthermore, the IVR point of contact yields critical patient data which can be used for outcomes management, identification, referral and triage for at-risk patients. The real-time database allows a clinical encounter to proceed through a path of questions and feedback which mimic the type of individualised care typical of face-to-face visits with a healthcare provider. A variety of IVR applications can be designed for use with phone systems. Both inbound and outbound automated phone services can deliver health information and clinical protocols that vary in complexity. Such systems also can be linked with clinical services delivered by live personnel and other technologies, such as demand publishing. This article reviews studies evaluating IVR phone applications in healthcare reminder systems, surveys, screening, assessments and disease management programmes. These trials demonstrate that automated phone intervention systems are a viable delivery channel for patient care. To date, the evidence available shows that computer-based phone services yield both high patient participation and retention and improved patient outcomes across a number of therapeutic areas. IVR appears to be a reliable and valid method for gathering patient data. Although some research suggests that response to these systems may differ in some subgroups of patients, no characteristics have consistently emerged. The majority of patients evaluate these services favourably. Further research should be designed to extend and clarify the current evidence concerning the impact and use of IVR. Such analyses must also address the overriding question of cost effectiveness and cost benefit, in order to provide return-on-investment information that will guide the design of future IVR phone systems.