Teletriage – Leading the way
By World Healthcare Journal-
A 111-style service can improve clinical outcomes and provide efficiency within a healthcare system, says Capita’s Senior Medical Officer Dr Charles Young
Around the world, healthcare systems are facing similar challenges presented by ageing populations. As we live longer, these systems face greater demand from patients with increasingly complex conditions. Across the Gulf Cooperation Council (GCC) region, sedentary lifestyles and consumption of sugary foods has led to a prevalence of non-communicable diseases (NCDs), particularly diabetes.
Overuse of costly emergency care services is also a pressing issue. In the UAE, for example, despite a large number of primary healthcare centres, emergency departments are faced with high numbers of minor complaints. In Abu Dhabi, data from 2012 illustrated that more than 75 per cent of cases in emergency departments (Eds) were non-urgent. These cases represent huge savings that can be made to healthcare organisations if over reliance on emergency services is reduced.
Across the GCC there is also a large discrepancy in accessibility to healthcare, with many people living in remote locations. Going forward, if the pressure on healthcare organisations is to be alleviated, it is important that people can access healthcare that enables them to manage their chronic conditions at home, without continued readmission to hospital.
Technology will be a key asset in tackling these problems.
One such technology solution is the adoption of computerised decision support algorithms and teletriage software. These digital tools enable clinicians and non-clinicians to quickly and accurately assess the urgency and severity of a patient’s symptoms. The result of this triage could be the provision of self-care advice, referral to local health services, or the dispatch of emergency personnel.
The adoption of computerised decision support algorithms and teletriage software also fosters a proactive approach to care, allowing people to access advice instantly, which may prevent a condition worsening to the point where emergency care is needed. In diverting people away from the emergency department, beds are made available for more serious cases, pressure on physicians is reduced, waiting times in emergency departments decrease, and healthcare costs are reduced.
Since computerised decision support algorithms and teletriage software have been introduced, they have been developed and improved to meet the needs of a wide range of health triage scenarios, from snake bite to heat stroke. Using a validated teletriage system also offers consistency in the assessment and prioritisation of care across the service.
Healthcare providers focused on delivering patient-focused care should be able to integrate patient data from multiple systems to provide truly individualised care, ensuring any assessment and advice given are specific to the patient and not just the condition.
Teletriage has the potential to radically transform care delivery and improve public health
Assessment via telephone is also an effective way of providing care to people with NCDs, either at home or a nearby facility, reducing the need for patients to use high-cost hospital care where possible. Patients with chronic conditions can be monitored remotely, and when all information relating to a patient is stored in a single record, a better continuity and consistency to co-ordinating their care can be achieved.
In addition, by using technology commonplace in everyday life, the health service removes socioeconomic barriers that might otherwise prevent someone accessing care, such as lack of transportation.
Teletriage enables populations to gain access to the right care advice at the time they need it, in turn improving clinical outcomes for patients, increasing the efficiency of healthcare organisations, and empowering people to look after their own health. In essence, teletriage has the potential to radically transform care delivery and improve public health.
Teletriage in action
Globally, organisations using Capita’s Healthcare Decisions (CHD) teletriage solution have carried out over 100 million patient assessments.
CHD’s decision management software enables the creation and deployment of end-to-end technology solutions in remote patient assessment and triage. The combination of TeleGuides (telephone triage), and WebGuides, (patient self-triage over the web, mobile app, or SMS), provides a robust, efficient and intuitive solution helping to relieve the burden placed on emergency services.
In an existing UK national triage service underpinned by CHD’s technology, CHD have created a significant change in the way the population accesses healthcare. CHD software combines a patient record and relationship management solution with sophisticated clinical decision support protocols. Instead of dialing the national number for the emergency services, people with an urgent but non-life threatening medical concern can dial an alternative national number and get help from a fully trained advisor 24 hours a day, seven days a week.
Looking for a robust, safe way of allowing patients to self-triage and where appropriate self-care, in combination with the free telephone helpline, the Australian state governments wanted to deploy a web triage system. The Healthdirect web self-triage service and national triage service, powered by CHD’s software, are now an important integral part of the Australian health system helping to alleviate pressure on GPs, emergency departments and ambulance services, especially in the after-hours periods.
Dr Charles Young is Senior Medical Officer for Capita plc., and Chief Medical Officer for Healthcare Decisions. Charles trained in medicine in London and continues to practice as an emergency physician at St Thomas’ hospital. For the last 15 years he has also worked in a range of clinical governance, evidence-based medicine, clinical decision support, and healthcare IT strategic leadership roles. Charles lectures internationally and is passionate about clinical governance and the interface between clinical information, healthcare technology, and clinical workflows. Charles is also a long-standing member of the UK’s National Institute for Health and Care Excellence (NICE) external accreditation committee, and The Cochrane Collaboration editorial overview committee. Charles’ role at Capita involves leading the clinical strategy and clinical governance program for all Capita health businesses and leading the clinical and decision support strategies for Healthcare Decisions.
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