Interactive voice system is versatile care partner
Automatic phone calls stretch dollars
A touch-tone phone connected to a computer can monitor your new mothers or your congestive heart failure patients. They answer preprogrammed "yes/no" questions by pressing keys on the phone’s keypad. Data such as blood sugars or body weight are entered as actual numbers.
The system, called interactive voice response (IVR), can monitor patients who need follow-up after the short hospital stays that managed care plans often require and save the cost of home care visits. According to Karen Hjerleid, spokeswoman for Kelly Homecare in Denver, the national average for home care visits is $28.
To participate in IVR monitoring, patients need nothing but a touch-tone phone. Your facility needs a computer programmed to ask the questions you want as well as a nurse on call to review the data and talk to patients if they wish.
They need a checkpoint’
St. Vincent installed its IVR when insurers shortened the length of stay for normal delivery to 48 hours.
"We can give patients a crash course in newborn care during their hospital stays, but do they retain it when they get home?" asks Melody Reeves, RN, follow-up program manager. "So much happens that first night at home with the baby. They need to have a checkpoint where they can ask what’s normal and what’s not."
Now St. Vincent’s new mothers go home with peace of mind and the assurance they’ll receive a conveniently scheduled call placed through the IVR technology asking how they and their babies are doing. (See list of questions inserted in this issue.) For instance, mothers have asked how many wet diapers to expect.
"We look for about six wet diapers a day in a healthy bottle-fed infant," Reeves says. Questions regarding the mother’s well-being include, "Have you noticed any foul odor from your discharge since you have been home?" One mother recently answered yes to that question, Reeves reports. A nurse, as always, promptly checked the patient’s response printout for signs that intervention was needed. "We knew this was a warning sign of possible infection," she continues. At the end of each 10- to 15-minute question set, the patient can talk to the nurse on call. Calls are monitored by nurses, who make prompt calls back if they see indications of problems.
Reeves immediately called and told the mom to contact her obstetrician. The uterine infection cleared up after a round of antibiotics.
"We see this early intervention as a way to prevent hospitalization or the need for crisis intervention for the mothers and the newborns," Reeves says.
IVR applications work in diverse settings
Prevention, health education and comprehension, monitoring of chronic illness, and medication compliance are all areas in which IVR can stretch providers’ time and medical dollars. Reeves notes that her follow-up line monitors 10 to 15 patients per day. It’s programmed to call every day, 10 to 12 hours per day, depending on what times are convenient for patients.
Unlike busy providers, IVR calls at intervals until it gets a live answer. Compare that with the maximum five to seven home care visits a licensed professional nurse could make in a given day, Reeves says.
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