title: The E-coach transition support computer telephony implementation study: protocol of a randomized trial.
abstract: BACKGROUND
  Patients requiring complex care are at high risk during the transition from one setting of care to another. Effective interventions to support care transitions have been designed but are very resource intensive. Telemonitoring has been considered as an approach to enhance care transition support, but many telemonitoring systems require special equipment or web-based interfaces to interact with patients and caregivers.
  
  
  METHODS
  In this paper we report our protocol for developing and testing E-Coach, an interactive voice response (IVR)-enhanced care transition intervention that monitors patients at home using their personal phone. The elements described include 1) development of an IVR monitoring system that will be based on Coleman's four pillars of care transition support; 2) development of a web-based "dashboard" of IVR responses that alert care transition nurses (CTN) of patient/caregiver concerns after discharge and allow documentation by the CTN when patients/caregivers are called; 3) pilot testing of the IVR system by patients and providers with refinement of the system based on patient/provider input; and 4) a pragmatic protocol for formal testing through a randomized controlled trial (RCT) of the E-Coach intervention in congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) patients admitted to a large tertiary hospital.
  
  
  BACKGROUND
  CT.gov#: NCT01135381.
authors.affiliation: University of Alabama at Birmingham (UAB) Division of Gerontology, Geriatrics and Palliative Care, Birmingham, AL 35294-2041, USA. critchie@uab.edu
authors.forename: Christine
authors.initials: C
authors.lastname: Ritchie
authors.forename: Joshua
authors.initials: J
authors.lastname: Richman
authors.forename: Heather
authors.initials: H
authors.lastname: Sobko
authors.forename: Eric
authors.initials: E
authors.lastname: Bodner
authors.forename: Barrett
authors.initials: B
authors.lastname: Phillips
authors.forename: Thomas
authors.initials: T
authors.lastname: Houston
mesh_terms: D002985:Clinical Protocols; D003142:Communication; D003201:Computers; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D020407:Internet; D018670:Monitoring, Ambulatory / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D012107:Research Design; D012648:Self Care; D017216:Telemedicine / Q000379:methods*; D014584:User-Computer Interface