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* From the Department of Veterans Affairs Medical Center (Ms. Young and Drs. Sparrow, Gottlieb, and Selim), Boston, MA; and the Medical Information Systems Unit (Dr. Friedman), Boston Medical Center, Boston University School of Medicine, Boston, MA.
Correspondence to: Melissa Young, BS, VA Medical Center (10C-35), 150 South Huntington Ave (151N), Boston, MA 02130; e-mail: morris.melissa{at}boston.va.gov
The current revolution in communications technology provides an opportunity for novel approaches to management of medical illness. As economic imperatives lead to a progressive reduction in the time that health-care providers spend with their patients, computerized, telephone-linked communication systems offer an inexpensive, widely available alternative with which patients and providers can maintain contact. Such systems may be particularly useful for providing ongoing monitoring and education of patients with chronic illnesses such as COPD. In this article, we describe the general application of telephone-linked communication systems in the health-care setting. We then present in detail one such system, which provides telephone-linked care for COPD (TLC-COPD). The operation of the system is described, as are its theoretical underpinnings in social learning theory. A randomized clinical trial currently is being performed to study the effects of the TLC-COPD system. The rationale for expected improvements in disease control and quality of life, and for a reduction in acute health-care utilization, is discussed.
Key Words: chronic bronchitis chronic disease computer COPD emphysema telecommunications telephone
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