Posted April 29, 2009

University of Ottawa and OHRI study shows automated telephone system can assist chronic disease management

OTTAWA — A new study published in the Canadian Medical Association Journal shows that an automated system is just as effective as a human in communicating with thrombosis patients about frequent dosing adjustments. The study also showed that the automated system was preferred by 77 per cent of patients and it reduced staff workload by 33 per cent. The Ottawa Hospital is now implementing the system throughout its thrombosis clinic.

“Automated telephone systems have become fairly common in health care and other fields, but this is the first study to look at providing therapy instructions without human intervention,” said senior author Dr. Alan Forster. “We are very encouraged by these results and pleased that all our patients will now have an opportunity to benefit from this system.”

Dr. Forster is an associate professor of medicine at the University of Ottawa, an internal medicine specialist at The Ottawa Hospital and a scientist at the Ottawa Hospital Research Institute (OHRI). He is a leading expert in patient safety and he has worked with Vocantas Inc., an Ottawa based company, for four years to develop the automated system, called an Interactive Voice Response System (IVRS) for various health care applications.

In the current study, Dr. Forster worked with University of Ottawa graduate student Natalie Oake and Dr. Marc Rodger, professor at the University of Ottawa and head of The Ottawa Hospital’s Thrombosis Program to customize the system for patients with thrombosis, a chronic blood-clotting disorder. This condition is diagnosed in more than 500,000 people per year in Canada and the US. Treatment with the blood thinner warfarin can greatly reduce the risk of re-developing these clots, but dosage must be adjusted weekly or even several times a week depending on blood test results. Typically, hospital staff spend hundreds of hours per week trying to relay blood test results and medication instructions to patients over the phone.

In the current study, the IVRS was integrated with a computerized decision support system to telephone patients and instruct them on how to adjust their warfarin dose. The system also reminded patients of upcoming appointments, followed-up on missed appointments and asked patients if they wanted to speak with someone from the clinic. It also asked about new prescriptions, so that staff could determine potential drug interactions.

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