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IVR
Interactive Voice Response (IVR) Technology
Interactive Voice Response (IVR) technology provides a means of interaction between an individual and a computer through the telephone using the touch-tone keypad or voice recognition. The IVR presents an automated script posing questions following a branching logic format based on caller responses. The logic, transparent to the caller, is used to collect specific information for immediate automated data entry to a relational database for concurrent and longitudinal analyses and feedback. With a dedicated toll-free number, access is ensured regardless of locale. Ninety-eight percent of American households have a telephone (U.S. Census, 2000). Thus, the IVR system provides a convenient, low-cost health care tool that is “on call” 24 hours a day, easy to use, and requires little technical training. IVR reported information has proven highly reliable and valid as compared to structured clinical interviews and medical record reviews (Perrine,1995; Pettite, 2000). The ease, convenience, and unobtrusiveness of the system contributes to a greater level of sensitive information reported and more accurate reporting as compared to traditional methods of retrospective data collection (e.g., time lag self reports, diaries). High compliance rates for daily IVR reporting have been reported for periods as long as 2 years (Pettite, 2000;, Searles, 1995, 2000). The start-up costs for IVR technology have fallen, offering a great potential for implementation with minimal resource allocation. In many ways, personal computers and the Internet provide an even richer medium for data collection between patients and health care providers than the telephone. Although use of computers is growing, only 76% of households have access to the Internet, and only 58% actually utilize web-based communication technology (U.S. Census Abstract, 2002). Many of the most needy patients and families have substantial social and economic barriers to computer access. Others are unfamiliar or uncomfortable with computers. Even those who use the Internet regularly may not have access at home or while traveling. We are optimistic that these barriers to computer use will continue to shrink and computers may become a useful part of the health care related data collection. However, the telephone is familiar, easy to use, and available today to nearly every American without additional investment, training or infrastructure. The logistics of programming and implementation of any survey within an IVR system is also transferable to web-based technology, thus the development of an IVR survey within this project allows expansion to a web-based approach at any time. For this proposal, the SmartQuest Pro version 4.3 IVR system software and Dialogic PCI voice board produced by Telesage are the primary equipment required to establish the IVR system (Telesage, 2003). Telesage specializes in automated and web-based technology for administering healthcare surveys and was funded by a National Institutes of Health SBIR grant. The system requirements for the SmartQuest Pro version 4.3 system include: Windows 2000 or NT PC platform, 128 MB of RAM, 1 GB hard drive, 1 Dialogic PCI voice board and driver per four telephone lines, a standard telephone line, and Microsoft Access for data processing and maintenance database. Paul Turner, Ph.D., will conduct the programming, implementation, and analyses of the IVR and the Family Evaluation of Hospice Care survey. Dr. Turner has extensive expertise in using IVR technology within the health care setting through funded research in the areas of asthma self-management (American Lung Association funded grant), depression management in primary care (MVP funded grant), and monitoring self-management of diabetes in primary care (NIH-NIDDK grant currently under review). References Cited
Perrine MW, Perrine MW, Searles JS, & Sester LS. (1995). Validation of daily self-reported alcohol consumption using interactive voice response (IVR) technology. Journal of Studies in Alcohol. 5, 487-90.
Piettie JD. (2000). Interactive voice response systems in the diagnosis and management of chronic disease. American Journal of Managed Care, 6, 817-27.
Searles JS, Perrine MW, Mundt JC, & Helzer JE. (1995). Self-report of drinking using touch-tone telephone: Extending the limits of reliable daily contact. Journal of Studies in Alcohol, 4, 375-82.
Searles JS, Helzer JE, Rose GL, & Badger GJ. (2002). Concurrent and retrospective reports of alcohol consumption across 30, 90, and 366 days: Interactive voice response compared to the timeline follow back. Journal of Studies in Alcohol, 63, 352-63.
TeleSage Incorporated. (2003). Seattle, WA: www.telesage.com
Statistical Abstracts of U.S. Census. (2002). Cyberstats: www.census.gov/statab/
United States Census Bureau. (2000). United States 2000 Census: www.census.gov/
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