Automated voice response enhances patient care

Previsit screening and counseling for parents using an automated interactive voice response (IVR) system integrated with electronic health records (EHRs) can improve pediatric primary care visits for both clinicians and parents, a new study reports.

Dermcase: Infant with a persistent nodular skin rash

The study recruited English-speaking parents of children aged from 4 months to 11 years from the Pediatric Primary Care Center at Boston (Massachusetts) Medical Center, which serves an ethnically diverse, primarily lower socioeconomic population. Before routine health maintenance and well-child visits, parents called the Personal Health Partner (PHP) system, which randomly assigned them to the PHP with counseling (293 patients) lasting an average of 29 minutes, or a control group (182 patients) that took an IVR safety survey lasting an average of 17 minutes.

Using the parents’ spoken responses, the PHP provided personalized counseling and goal setting for the upcoming office visit and transferred data to the patient’s EHR for review during the visit. Controls received safety advice at the end of the automated survey related to unsafe behaviors they reported. Their data were not entered into the EHR.

After the visit, participating parents and clinicians were called to evaluate comprehensiveness of screening and counseling, medication assessment and management, and satisfaction with the process.

Parents who used the PHP system were more likely than controls to discuss depressive symptoms (their own; 42.6% vs 25.4%) and prescription medication (their child’s; 85.7% vs 72.6%). They also reported being better prepared for visits (81% vs 67%).

Both PHP parents and controls liked the automated system because they could access it at home by telephone, although 40% said they’d rather use an Internet-based system. Most said the length of the call was reasonable, but PHP parents were less likely than controls to say so (74% vs 90%, respectively).

All participating clinicians said that using the PHP improved the quality of their care by, for example, reminding them about things they might forget. Most found the PHP system easy to use.

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