Computer telephony: automated calls for medical care.
BACKGROUND
The computer telephony system (CTS) combines computer and telephone to automate the collection, processing and dissemination of information. Many innovative applications of the CTS have emerged. In this article we summarize the evidence for CTS-based medical interventions based on randomized controlled trials.


METHODS
We searched for trials in MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials, and bibliographies of retrieved articles, review articles and textbooks. We excluded non-English articles and those pertaining to psychology, addiction, psychiatry, research and education.


RESULTS
In health care delivery, 3 of 4 trials of CTS-based interventions improved clinic show rates. In preventive health care, 4 of 5 showed higher childhood immunization rates. For nutrition, 2 small trials showed no clear benefit in cholesterol lowering or in weight reduction, but 1 trial showed a benefit in fibre intake. For increasing physical activity, 1 smaller trial showed no benefit but a larger one did. For medical management of chronic conditions, 1 trial showed improved hemoglobin A(1c) levels and 1 trial showed better processes of care in diabetes. In hypertension management, 1 trial found better adherence to medication regimens and control of blood pressure. In outpatient oncology care, 1 trial showed better supportive care. For support of caregivers for dementia patients, 1 trial showed no benefit. One small trial showed better adherence to medication in seniors.


CONCLUSIONS
The CTS has diverse applications in medical care; however, the evidence for these is limited. Despite being impersonal, the reliability and availability of the CTS make it attractive for reminders and follow-up. More research is needed to determine the role of the CTS in medical care.
Division of General Internal Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Sask. biem@skyway.usask.ca
H Jay
HJ
Biem
Roger W
RW
Turnell
Carl
C
D'Arcy
D001331:Automation; D003201:Computers; D003695:Delivery of Health Care / Q000379:methods*; D006801:Humans; D011314:Preventive Health Services / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D013689:Telephone / Q000295:instrumentation*; D014584:User-Computer Interface; D014831:Voice