International Journal for Quality in Health Care Advance Access published online on May 20, 2008
International Journal for Quality in Health Care, doi:10.1093/intqhc/mzn021
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Developing an automated speech-recognition telephone diabetes intervention
1 Center for Primary Care and Prevention, The Warren Alpert Medical School of Brown University/Memorial Hospital of Rhode Island, Pawtucket, RI, USA
2 Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA
3 Department of Veterans Affairs Center for Practice Management and Outcomes Research, University of Michigan, Ann Arbor, MI, USA
4 Department of Family Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
Objective. Many patients do not receive guideline-recommended care for diabetes and other chronic conditions. Automated speech-recognition telephone outreach to supplement in-person physician–patient communication may enhance patient care for chronic illness. We conducted this study to inform the development of an automated telephone outreach intervention for improving diabetes care among members of a large, not-for-profit health plan.
Design. In-depth telephone interviews with qualitative analysis.
Setting/participants. Individuals with diabetes (n = 36) enrolled in a large regional health plan in the USA.
Main outcome measure. Patients' opinions about automated speech-recognition telephone technology.
Results. Patients who were recently diagnosed with diabetes and some with diabetes for a decade or more expressed basic informational needs. While most would prefer to speak with a live person rather than a computer-recorded voice, many felt that the automated system could successfully supplement the information they receive from their physicians and could serve as an integral part of their care. Patients suggested that such a system could provide specific dietary advice, information about diabetes and its self-care, a call-in menu of information topics, reminders about laboratory test results and appointments, tracking of personal laboratory results and feedback about their self-monitoring.
Conclusions. While some patients expressed negative attitudes toward automated speech recognition telephone systems generally, most felt that a variety of functions of such a system could be beneficial to their diabetes care. In-depth interviews resulted in substantive input from health plan members for the design of an automated telephone outreach system to supplement in-person physician–patient communication in this population.
Keywords: information technology, intervention development, qualitative methods, quality of care
Address reprint requests to: Steven Simon; Tel: + 1-617-509-9938; Fax: + 1-617-859-8112; E-mail: steven_simon{at}hphc.org
Accepted for publication April 26, 2008.