title: Automated conversation system before pediatric primary care visits: a randomized trial.
abstract: OBJECTIVE
  Interactive voice response systems integrated with electronic health records have the potential to improve primary care by engaging parents outside clinical settings via spoken language. The objective of this study was to determine whether use of an interactive voice response system, the Personal Health Partner (PHP), before routine health care maintenance visits could improve the quality of primary care visits and be well accepted by parents and clinicians.
  
  
  METHODS
  English-speaking parents of children aged 4 months to 11 years called PHP before routine visits and were randomly assigned to groups by the system at the time of the call. Parents' spoken responses were used to provide tailored counseling and support goal setting for the upcoming visit. Data were transferred to the electronic health records for review during visits. The study occurred in an urban hospital-based pediatric primary care center. Participants were called after the visit to assess (1) comprehensiveness of screening and counseling, (2) assessment of medications and their management, and (3) parent and clinician satisfaction.
  
  
  RESULTS
  PHP was able to identify and counsel in multiple areas. A total of 9.7% of parents responded to the mailed invitation. Intervention parents were more likely to report discussing important issues such as depression (42.6% vs 25.4%; P < .01) and prescription medication use (85.7% vs 72.6%; P = .04) and to report being better prepared for visits. One hundred percent of clinicians reported that PHP improved the quality of their care.
  
  
  CONCLUSIONS
  Systems like PHP have the potential to improve clinical screening, counseling, and medication management.
authors.affiliation: General Pediatrics, badams@bu.edu.
authors.forename: William G
authors.initials: WG
authors.lastname: Adams
authors.affiliation: Research Department, VA Central Western Massachusetts, Leeds, Massachusetts; and.
authors.forename: Barrett D
authors.initials: BD
authors.lastname: Phillips
authors.affiliation: Health Policy and Management.
authors.forename: Janine D
authors.initials: JD
authors.lastname: Bacic
authors.affiliation: Anderson Center and General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Walsh
authors.affiliation: General Internal Medicine, Boston University/Boston Medical Center, Boston, Massachusetts;
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Shanahan
authors.affiliation: General Internal Medicine, Boston University/Boston Medical Center, Boston, Massachusetts;
authors.forename: Michael K
authors.initials: MK
authors.lastname: Paasche-Orlow
mesh_terms: D000328:Adult; D001331:Automation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003376:Counseling / Q000379:methods* / Q000639:trends; D057286:Electronic Health Records / Q000639:trends; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000379:methods* / Q000639:trends; D011320:Primary Health Care / Q000379:methods* / Q000639:trends; D049250:Speech Recognition Software / Q000639:trends; D014584:User-Computer Interface
keywords: electronic health record; health information technology; interactive voice response; patient activation; patient-centered; primary care; routine health care maintenance; telephony; well-child visit