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: 2.034_TEC Midterm evaluation of health-provider alert functionality in a program of automated telephone monitoring and self-care support for diabetic patients in Colombia J. Tasset, C. Bourdillon, R. Philson, M. Gomez, S. Ferguson, J.H. Velasquez Molina, N.L. Salazar Marulanda, N. Marinec, J.F. Saldarriaga Franco, J. Piette; The University of Michigan Medical School Global REACH, Ann Arbor, USA, La Universidad de Antioquia Living Lab Telesalud, Medellin, Colombia, University of Michigan School of Public Health Center for Managing Chronic Disease, Ann Arbor, USA Purpose: Trials suggest that mobile health (m-health) interventions can improve self-care behaviors and outcomes for patients with diabetes mellitus (DM) [1,2]. Llamada Saludable is interactive voice response (IVR) m-health program used to monitor DM patients and provide self-care education between outpatient visits. The program was implemented in Medellin, Colombia from JulySeptember 2015 in collaboration with the Living Lab Telesalud program at the Universidad de Antioquia and a large insurer for low-income patients (SaviaSalud). In addition to evaluating effects on DM management, this trial assessed the provider alert system with real-time monitoring of patient-reported adverse health events. Methods: 150 DM patients received weekly, automated calls for 12 weeks. At program entry, patients received education on healthy living and DM symptom management. Patients were informed they would receive a follow-up call from a health professional if their responses indicated a need for additional assistance. During IVR calls, patients answered questions using touch-tone phones, which triggered automated email alerts to clinical staff. Paramedics completed less critical follow-up calls while physicians called insulin dependent patients reporting blood sugar <90 mg/dl or >300 mg/dl. Outcomes and Evaluation: Participants completed roughly 1,300 IVR assessments (72%) and clinicians received 319 email notifications regarding 129 individuals. Although clinicians were concerned about the potential for patients to exploit the alert feature to quickly access a physician, patients expressed reassurance that providers were “accompanying” in their illness. Amajority of follow-up (87.5%) included selfcare education, while only 6.2% resulted in advising the patient to visit their primary care physician (5.9%) or emergency services (0.3%). Going Forward: Based on this successful pilot, the Llamada Saludable program is expanding to additionalmunicipalities aroundMedellin and other chronic diseases (e.g., renal disease, COPD). The functionality of the alert aspect of the program is integral to sustainability and scaling so the system is responsive to adverse health events. Our experience indicates institutions implementing m-health programs with provider-alert feedback mechanisms should consider their role as patient education rather than solely an emergency response system.

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