| ExcelicareTM Direct at Glasgow Royal Infirmary monitors rheumatology patients at home for medication compliance and side effects
In a pioneering project utilising Interactive Voice Response (IVR) technology, the Centre for Rheumatic Diseases at Glasgow Royal Infirmary chose ExcelicareTM Direct 3 years ago, to monitor patients at home.
Drugs prescribed for the treatment of rheumatoid arthritis must be taken in the correct dosage and in the correct manner to be effective, while regular blood and urine monitoring is essential to avoid potentially toxic side effects. The close monitoring required by this group of patients has traditionally meant regular follow up visits to the outpatients department.
By using ExcelicareTM Direct, Dr. Rajan Madhok, Consultant Rheumatologist at the GRI, monitors his patients more closely, reviews their progress and gives them immediate feedback, all without increasing the frequency of their visits to his clinic. A secondary long-term objectives is to improve compliance with treatment, reduce side effects and educate his patients.
Using an ordinary touch-tone phone, patients dial a dedicated number to call up the ExcelicareTM Direct system. Having identified them by their secure PIN, the system delivers a personalised questionnaire 'script' to which they respond by pressing the appropriate touch-tone keys. All responses are recorded in an interaction log and specific data items are entered directly into forms in their patient record. Because ExcelicareTM Direct can interrogate and write back into the patient record, it has the power to interpret patients' responses.
By comparing them with expected values entered in their record, enabling scripts to be delivered dynamically each time they call. Certain responses have been set to trigger alerts or generate educational messages, and these are also indicated in the log. Additionally patients can choose to leave voicemail messages for the clinical team.
The project, which kicked off in Oct' 2001, has been very well received by patients. Initial feedback indicates that patients appreciate the increased access to their clinical team and feel reassured by the knowledge that their doctor is aware of their progress. Significantly, patients of all ages also report finding the system very easy to use.
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