A preliminary study of a cloud-computing model for chronic illness self-care support in an underdeveloped country.
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Date
2011-05-13
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Abstract
BACKGROUND Although interactive voice response IVR calls can be an effective tool for chronic disease management many regions of the world lack the infrastructure to provide these services PURPOSE This study evaluated the feasibility and potential impact of an IVR program using a cloud computing model to improve diabetes management in Honduras METHODS A single group pre post study was conducted between June and August 2010 The telecommunications infrastructure was maintained on a U S server and calls were directed to patients cell phones using VoIP Eighty five diabetes patients in Honduras received weekly IVR disease management calls for 6 weeks with automated follow up e mails to clinicians and voicemail reports to family caregivers Patients completed interviews at enrollment and a 6 week follow up Other measures included patients glycemic control HbA1c and data from the IVR calling system RESULTS A total of 53 of participants completed at least half of their IVR calls and 23 of participants completed 80 or more Higher baseline blood pressures greater diabetes burden greater distance from the clinic and better medication adherence were related to higher call completion rates Nearly all participants 98 reported that because of the program they improved in aspects of diabetes management such as glycemic control 56 or foot care 89 Mean HbA1c s decreased from 10 0 at baseline to 8 9 at follow up pUnder0 01 Most participants 92 said that if the service were available in their clinic they would use it again CONCLUSIONS Cloud computing is a feasible strategy for providing IVR services globally IVR self care support may improve self care and glycemic control for patients in underdeveloped countries
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Keywords
Client, Pre-prototype, Feasibility, Chronic care, Health education or promotion, Voice, Audio, IVR