IVR Care Transition Systems recently launched an innovative telephone survey product that promises to reduce health care costs by helping hospitals, physicians and other health care providers keep tabs on their patients’ health conditions.

“The goal is to stay on top on warning signs of potential medical problems in order to prevent delayed treatment, unnecessary emergency room visits and hospital readmissions,” says Heather Sobko, PhD, RN, founder of IVR CTS.

Patients who need monitoring following a hospital visit, say for a stroke for example, are contacted periodically by the IVR CTS automated interactive voice response telephone system. The patient knows the call will be coming and can schedule the interview for a specific and convenient time. The system can be used with any cellular or land-line telephone or any smart device capable of receiving a phone call.

Survey questions, asked by an expressive human vs. computer-generated voice, are designed to uncover potential patient needs such as a medication adjustment, a doctor visit or other provider support. Survey questions can be tailored to specific medical concerns. “The system’s voice gives patients the sense that their issues are being responded to with understanding,” says Donald Schnader, the company’s chief technology officer.


Patient answers are then delivered to the provider’s healthcare review team via a secure computer network. Patients with the most pressing concerns are automatically triaged for attention by the system. When potential problem areas are detected during staff review live follow-up calls are made by the appropriate healthcare staff member. “The average person often doesn’t know which symptoms are of major or minor concern. They may be hesitant to call their doctor about what seems to be a small problem, but actually signals a big one,” Sobko says.

Patient answers can also be used to create a data base that can generate clinical reports as needed and can be mined for various uses, including evidence-based care. Sobko foresees the system being used to generate proof that in some cases hospital readmissions cannot be avoided even with the best of communication with the patient. In such cases readmissions should be covered by insurance providers including Medicaid, she argues.


Sobko believes the voice response product has the potential to transform the health care industry by reducing costs, promoting evidence-based care, providing proactive care, and even saving lives. “Twenty percent of the population with chronic, complex conditions generates 80 percent of health care costs. Those costs can be reduced by better patient monitoring,” Sobko says.


Through her research in nursing informatics, Sobko has seen what a difference good communication makes in patient outcomes. She was particularly inspired by a study she participated in that showed a significant decrease in hospital readmissions and better outcomes through the use of an automated phone survey. “The survey we used had many limitations, but it made me realize the potential of patient monitoring with an interactive voice response system,” Sobko says.


Sobko’s unique background includes advanced degrees in psychology and sociology as well as nursing. Her clinical work has been in the areas of heart and lung transplantation, geriatric psychiatry, other elder care issues, and chronic disease management.

In addition to her research, teaching and scholarship, Sobko has been active in nursing informatics on a national level. She is chair of the American Medical Informatics Association Membership and Outreach Committee and of the AMIA Nursing Informatics Working Group Membership Committee. Locally, Sobko is on Southern Research Institute’s  Institutional Biosafety Committee.

Sobko assembled a team of 30 experts in their fields to create the IVR CTS voice response survey system. The system was developed based on the team’s clinical experience in chronic disease management, multiple morbidities, and care transitions. The system was tested in clinical settings as it was being developed. “We’re pleased to be able to present a product that provides such a comprehensive, multi-level look at patient care transitions,” Sobko says.


 Applications for the system likely will go beyond the initial projected uses for hospitals and doctors’ offices, to include home-health and hospice care providers. “The technology is adaptable to many uses,” Schnader says.