Rapid design and implementation of an integrated patient self-triage and self-scheduling tool for COVID-19.
J Am Med Inform Assoc
; 27(6): 860-866, 2020 06 01.
Article
in English
| MEDLINE | ID: covidwho-42077
ABSTRACT
OBJECTIVE:
To rapidly deploy a digital patient-facing self-triage and self-scheduling tool in a large academic health system to address the COVID-19 pandemic. MATERIALS ANDMETHODS:
We created a patient portal-based COVID-19 self-triage and self-scheduling tool and made it available to all primary care patients at the University of California, San Francisco Health, a large academic health system. Asymptomatic patients were asked about exposure history and were then provided relevant information. Symptomatic patients were triaged into 1 of 4 categories-emergent, urgent, nonurgent, or self-care-and then connected with the appropriate level of care via direct scheduling or telephone hotline.RESULTS:
This self-triage and self-scheduling tool was designed and implemented in under 2 weeks. During the first 16 days of use, it was completed 1129 times by 950 unique patients. Of completed sessions, 315 (28%) were by asymptomatic patients, and 814 (72%) were by symptomatic patients. Symptomatic patient triage dispositions were as follows 193 emergent (24%), 193 urgent (24%), 99 nonurgent (12%), 329 self-care (40%). Sensitivity for detecting emergency-level care was 87.5% (95% CI 61.7-98.5%).DISCUSSION:
This self-triage and self-scheduling tool has been widely used by patients and is being rapidly expanded to other populations and health systems. The tool has recommended emergency-level care with high sensitivity, and decreased triage time for patients with less severe illness. The data suggests it also prevents unnecessary triage messages, phone calls, and in-person visits.CONCLUSION:
Patient self-triage tools integrated into electronic health record systems have the potential to greatly improve triage efficiency and prevent unnecessary visits during the COVID-19 pandemic.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Patient Participation
/
Appointments and Schedules
/
Pneumonia, Viral
/
Triage
/
Medical Records Systems, Computerized
/
Coronavirus Infections
/
Diagnostic Self Evaluation
/
Pandemics
/
Patient Portals
/
Betacoronavirus
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Humans
Country/Region as subject:
North America
Language:
English
Journal:
J Am Med Inform Assoc
Journal subject:
Medical Informatics
Year:
2020
Document Type:
Article
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