The E-Coach transition support computer telephony implementation study: Protocol of a randomized trial

Ritchie, Christine S.; Richman, Joshua S.; Sobko, Heather J.; Bodner, Eric; Phillips, Barrett D.; Houston, Thomas K.

doi:10.1016/j.cct.2012.08.007

Cited by 14 publications

(20 citation statements)

References 12 publications

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“…with response options of "excellent, very good, good, fair, or poor" [23]. A detailed study protocol, including the statistical analysis plan, has been previously published [22]. The trial had a number of pragmatic aspects [24], including that the implementation of the system was supported by our healthcare system partner, not research funding [22].…”

Section: Methodsmentioning

confidence: 99%

“…A detailed study protocol, including the statistical analysis plan, has been previously published [22]. The trial had a number of pragmatic aspects [24], including that the implementation of the system was supported by our healthcare system partner, not research funding [22]. We also allowed flexibility on the part of CTNs in recruitment and follow-up.…”

Section: Methodsmentioning

confidence: 99%

“…The IVR was introduced as "Ida" (Interactive Discharge Assistant). The Ida IVR was programmed [22] to perform three primary functions: (1) collect data from patients tailored to CHF or COPD that would be considered transitional care "red flags" in accordance with the care transitions literature [5] (e.g., questions about medications, escalating symptoms, insufficient clinical followup); (2) provide customized patient education and motivation during the Ida IVR calls based on patients' response to questions; and (3) alert the CTN when patient responses to the Ida IVR indicated patient red flags. Ida IVR calls, though structured similarly, differed in content between COPD and CHF (see Table 1 for example questions for both conditions).…”

Section: Setting and Participantsmentioning

confidence: 99%

“…Sample size Our target sample size was 241 subjects per group to provide 80 % power to detect a difference in the main outcome, rehospitalization rates, of 17.7 versus 8.7 or 22 versus 12 % using twosided chi-square tests [22].…”

Section: Setting and Participantsmentioning

confidence: 99%

“…We developed E-Coach, a technology-assisted care transition intervention designed to reduce the burden on care transition nurses (CTN) engaging in traditional care transition interventions, which often involves home visits and multiple live "proactive" phone calls [22]. E-Coach integrates a proactive daily assessment IVR system (which eliminates proactive calls by CTNs) with a web-accessible dashboard for CTN.…”

Section: Introductionmentioning

confidence: 99%

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The E-Coach technology-assisted care transition system: a pragmatic randomized trial

Ritchie

Houston

Richman

et al. 2016

Behav. Med. Pract. Policy Res.

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Care transitions from the hospital to home remain a vulnerable time for many patients, especially for those with heart failure (CHF) and chronic obstructive pulmonary disease (COPD). Despite regular use in chronic disease management, it remains unclear how technology can best support patients during their transition from the hospital. We sought to evaluate the impact of a technology-supported care transition support program on hospitalizations, days out of the community and mortality. Using a pragmatic randomized trial, we enrolled patients (511 enrolled, 478 analyzed) hospitalized with CHF/COPD to "E-Coach," an intervention with conditionspecific customization and in-hospital and postdischarge support by a care transition nurse (CTN), interactive voice response post-discharge calls, and CTN follow-up versus usual post-discharge care (UC). The primary outcome was 30-day rehospitalization. Secondary outcomes included (1) rehospitalization and death and (2) days in the hospital and out of the community. ECoach and UC groups were similar at baseline except for gender imbalance (p = 0.02). After adjustment for gender, our primary outcome, 30-day rehospitalization rates did not differ between the E-Coach and UC groups (15.0 vs. 16.3 %, adjusted hazard ratio [95 % confidence interval]: 0.94 [0.60, 1.49]). However, in the COPD subgroup, ECoach was associated with significantly fewer days in the hospital (0.5 vs.

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