IVR Intervention

Besides its typical use in customer service interactions, IVR systems have recently been deployed for more experimental purposes. Last year, two National Institute of Health studies were utilizing the technology as a way of conducting real-time in situ phone interviews with research subjects who were battling substance abuse. A new paper appears to demonstrate a similar application for primary care preventive service providers. The paper published in the Journal of General Internal Medicine describes a pilot study using an IVR system in alcohol screening and brief intervention for patients who were heavy drinkers.

After an office screening by a physician, the subjects interacted with a mixture of human-operated and IVR systems outside of the office as a means to dissuade them from drinking to excess. Interactions only lasted from three to seven minutes, but helped reduce alcohol use by an average of 25% among subjects two weeks after the initial office visit. Approximately 40% of subjects who utilized the IVR system reported that it helped motivate them to change their drinking behavior. Furthermore, subjects who experienced both human-operated and IVR systems indicated that they were more at ease with the automated intervention technology. This study only represents a small sample and was conducted to test feasibility of larger scale studies in the future but the results do indicate that an IVR system could be very useful in helping heavy drinkers change their behavior.

IVR Year in Review

Historians will remember 2009 for many different reasons although chief among them will likely be the worldwide economic downturn and its effects on business. The IVR industry suffered as much as any, but there were several bright spots throughout the year. Despite some people writing off IVR systems as a mature product on the decline, there were several innovative uses of the technology that will almost certainly sustain it for years to come. Some novel uses include business continuity management systems created and implemented for the H1N1 pandemic (1, 2, 3) and other unforseen catastrophes. There were also many novel implementations of IVR in health care management and delivery including virtual medical clinics, out-patient monitoring and followup/medication reminder services. In addition, academic researchers found potential benefits from the use of IVR by making it easier for test subjects to submit real-time data via mobile phones while outside of the laboratory environment.

Despite the advances and new uses of the technology and potential for future growth in more traditional applications, there are still many common mistakes being made during the design and implementation that need to be addressed in order for companies to fully capitalize on the power of IVR. Several individuals and companies in and outside of the industry have complied very good lists of common problems and other considerations that should be made before rolling out an IVR system (1, 2, 3, 4, 5, 6, 7). By creating lists of best practices and learning from internal mistakes and customer feedback, IVR has potential uses for many years to come. It appears that 2010 will continue to be a difficult time for many companies, but those that work to improve their products and exceed customer expectations should weather the storm and flourish when the economic recovery begins in earnest.

Over the course of the year, this blog has been a work in progress and we want to thank everyone for spending a few minutes reading our posts each week. Please feel free to discuss any of our past or future articles in the comments section. Together we can make this blog and others like it forums for progress and improvement in the IVR industry. All of us at Universal Digital Productions would like to wish everyone a safe, happy and prosperous new year. See you in 2010!

Academic Research Through IVR

IVR technology has been used widely for many purposes beyond customer service including automated opinion polling and market research questionnaires. Behavioral researchers at the University of Buffalo have taken it a step further and are currently applying the technology in two National Institute of Health funded studies. The research involves investigating the effects of alcohol, marijuana and the situational behaviors that are associated with their use. The IVR systems are configured to make random calls to subjects' cell phones and conduct surveys of their experiences with respect to their use of alcohol and marijuana.

In the past, these studies have relied on subjects taking surveys at scheduled times and giving their responses based on remembering what they were thinking and feeling at moments in the past. With the use of IVR technology, subjects can be inconspicuously surveyed over their cell phones while they are actually partaking in alcohol or marijuana and can give much more relevant responses. Not only does this give more pertinent data for the study, but it also increases the privacy of participants. The true test of this survey methodology and it's future will be to see how it compares with similar studies conducted in more traditional manners.

IVR and H1N1: Round Three

As fall begins in North America, there is a heightened level of anxiety about the flu spurred by fears of an H1N1 pandemic. Earlier this year, the outbreak that began in Mexico and quickly spread around the world was a bit over-hyped by incessant media reports about growing numbers of cases and deaths caused by the virus. The initial outbreak occurred near the end of the flu season in the northern hemisphere so it's effects were likely less than if the outbreak had occurred at the beginning of the season. Now that North America is entering a new flu season, more precautions than usual are taking place in businesses and schools to avoid being dramatically impacted by the H1N1 virus.

Earlier this year, many technologies were employed in various ways around the world to disseminate information about the spread of the flu and where individuals could seek medical treatment if infected. The health ministry of India deployed an informational IVR system to offer advice for those infected while some colleges in Canada implemented proactive IVR systems to periodically monitor student health. SoundBite has recently joined the fray with the introduction of an IVR system that will not only keep employees informed about the latest H1N1 news but will also make outbound notification calls when on-site flu shots are to be administered. This proactive approach is an effort to minimize the number of employees that are affected by the virus causing them to miss work. In this rapidly shrinking world, the issue of a global pandemic is more real than ever and preparedness is key to avoiding a health disaster. Of course, a preemptive strategy is only part of a business continuity plan and organizations must be prepared if they are unable to contain an outbreak among employees.

Integrated Health Care IVR

With the health care debate continuing in the United States, many companies have introduced innovative solutions to help in health care management through IVR technologies. From appointment notifications and followup care to maximizing doctors' appointment schedules, several specific programs have been unveiled in the past few months to help save both time and money. Now CallFire.com has unveiled an IVR solution that combines many of these concepts into one convenient package.

In addition to offering appointment reminders to patients, the CallFire system can be configured to quickly fill canceled appointments by making automated outbound calls to patients on a waiting list. Further customization options allow for the patient data to be integrated in such a way that outbound calls can be personalized. The IVR system is also capable of making followup calls after appointments and surgeries to ensure that patients adhere to post-visit instructions. Most importantly, the system collects patient feedback through voice response surveys that assist in improving services and overall medical care offered by the physician. Continued advances and integration of IVR technology into the medical profession will undoubtedly help save time and money for doctors and patients alike.

Another Medical Application of IVR

In an ongoing effort to use technology to improve medical care, many forms of IVR systems have been implemented in many stages of the treatment process. From simply finding an available physician to complex follow-up after a hospital stay, IVR systems are helping doctors provide better care for patients at decreased costs. Houston, TX based HealthHelp has found a way to further improve their management of radiology benefits to allow for twenty-four hour service through an IVR system.

HealthHelp manages a clinical database to assist physicians in choosing the best radiology solution for a particular diagnosis. Under the previous system, doctors were limited to using a call center and/or online form to interface with the service. The system was further limited by the fact that it was only staffed during certain hours of the day. Qwest recently developed an IVR system for HealthHelp that collects the pertinent insurance information, American Medical Association (AMA) codes and specific clinical queries that allow the automation to quickly process and approve the necessary medical tests. As a result, the correct medical test can be determined and conducted at any hour of the day thus allowing for more responsive medical care. A widespread development and adoption of this type of application could conceivably save many lives and health care dollars around the country and the world.

Automated Medical Followup

The ongoing healthcare debate in the United States has been spurred by many things, chief among them are the rising costs of medical care. Regardless of the outcome of the debate and future legislation, improved care and reduced costs should always be a goal to strive for in the medical field. Audiopoint has recently released a product that aims to do just that. NotifierRx is a telephone based application that can be used to communicate and follow-up with discharged patients to monitor their recovery and address any problems in a timely manner.

The recovery period following a hospital stay is fraught with opportunities for relapse or infection that can result in a costly readmission for care. NotifierRx communicates important recovery and medication reminders to patients but also allows for medical staff to acquire specific follow-up information. The patient can be asked a series of questions through an IVR system and his or her spoken answers are recorded for the physician to review. Based on the questions, appropriate actions can be taken quickly that could result in outpatient or even in-home care saving both time and money that would otherwise be spent during the readmission to the hospital. Time is of the essence in medical care and using automated systems to help with patient monitoring can shorten the response times and achieve cost savings and improved customer care.

IVR in NHS

Throughout the debate over government involvement in health care in the United States, many on both sides have pointed to the successes and failings of the national services offered by Canada and the United Kingdom. Efficiency is always a popular topic of discussion and while inefficiencies are inherent in almost any system, recent initiatives by hospitals in the UK's National Health Service (NHS) are making efforts to save money and time for both doctors and patients.

According to internal statistics, almost fifteen percent of patients miss scheduled hospital appointments. This results in fewer patients being treated by doctors as well as puts a financial strain on the NHS system. Using a combination of text-to-speech and IVR technologies, NHS hospitals are automatically calling patients seven days prior to appointments to confirm the date and time of scheduled visits. Since implementation, the hospitals have seen a "significant improvement" in appointment attendance as well as shorter waiting lists for other patients to see doctors. It is unclear if recent research published in the Canadian Medical Association Journal influenced this project, but it appears to produce similar benefits for both patients and doctors alike.

IVR and H1N1: Round Two

Last month the spread of the H1N1 virus had slowed considerably in North America but cases were beginning to erupt in other parts of the world. As a result, the health ministry of India created an IVR help line for residents to access updates about the outbreak as well as get help in locating medical assistance. Although it is still summer in North America, many local and state governments are preparing for the upcoming flu season that in some places could begin as early September.

Several colleges around Ottawa, Canada are developing IVR systems to monitor and contain any outbreak that might occur in their on-campus residence halls. Algonquin College is using a system that will periodically call all students to poll them on any flu-related symptoms they might be feeling. The college administrators will then be able to use this "snapshot" as a means for making decisions about canceling classes to minimize student contact. As the threat of the H1N1 virus returns this fall, there will likely be more localized IVR systems implemented to deal with dissemination of information about the flu.

Virtual Walk-In Clinic

A new service based in California offers a creative approach to dealing with the rising costs and decreased productivity for doctor's office visits. Doctors on Demand Health Networks provides a virtual walk-in clinic for patients seeking quick, non-emergency related health care. The network consists of a pool of licensed physicians who are seeking additional work hours without the need to hire more staff to assist in scheduling and record keeping. A doctor in the network simply notifies the system when he or she has had a patient cancellation and the network will attempt to match someone in need to that doctor at that open appointment time.

Patients enroll in the service by phone through an IVR system that collects their contact information, medical histories and current health issues. Doctors who are available for an appointment can listen to the patient medical histories as well as voice notes left by other doctors in the system. The system then notifies the patient of the appointment with the best available doctor for the particular health issue. After the appointment, the doctor can then use the IVR system to record notes on the visit. Additionally, the system handles billing and electronic record keeping for the visit.

This is, of course, not a replacement for traditional family practitioners nor is it legally allowed as primary care. Rather, it is a way for doctors who have spare time and desire for extra work to help more people. Furthermore, this approach could potentially be employed by other appointment-based businesses in an effort to cut costs and improve efficiency.

A Novel Use of IVR

Medical science has made tremendous strides in developing treatments to chronic illnesses that, in the past, were usually terminal. Many treatments to such illnesses require vigilant monitoring of a patient's blood chemistry. These can range from routine home monitoring of blood sugar levels for diabetics to regularly scheduled blood tests for patients suffering from blood clotting disorders.

A study published in the April 28th issue of the Canadian Medical Association Journal tested the use of IVR in communicating with patients undergoing anticoagulation therapy. The rigorous treatment involves periodic blood testing and medication to maintain normalized levels of clotting factors in the blood. For the study, an IVR system was implemented that contacted the patients to communicate medication reminders, blood testing appointment times and notifications when appointments were missed. At the conclusion of the study, the authors found that the workload on the staff was reduced by 33% and some patients asked to continue the service as a way to manage their treatments. More research is certainly required, but this study indicates the potential of IVR as a part of medical therapy.