Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Center for Digital Health Innovation, University of California San Francisco, San Francisco, California, USA.
J Am Med Inform Assoc. 2022 Nov 14;29(12):2066-2074. doi: 10.1093/jamia/ocac161.
Symptom checkers can help address high demand for SARS-CoV2 (COVID-19) testing and care by providing patients with self-service access to triage recommendations. However, health systems may be hesitant to invest in these tools, as their associated efficiency gains have not been studied. We aimed to quantify the operational efficiency gains associated with use of an online COVID-19 symptom checker as an alternative to a telephone hotline.
In our health system, ambulatory patients can either use an online symptom checker or a telephone hotline to be triaged and connected to COVID-19 care. We performed a retrospective analysis of adults who used either method between October 20, 2021 and January 10, 2022, using call logs, electronic health record data, and local wages to calculate labor costs.
Of the 15 549 total COVID-19 triage encounters, 1820 (11.7%) used only the telephone hotline and 13 729 (88.3%) used the symptom checker. Only 271 (2%) of the patients who used the symptom checker also called the hotline. Hotline encounters required more clinician time compared to those involving the symptom checker (17.8 vs 0.4 min/encounter), resulting in higher average labor costs ($24.21 vs $0.55 per encounter). The symptom checker resulted in over 4200 clinician labor hours saved.
When given the option, most patients completed COVID-19 triage and visit scheduling online, resulting in substantial efficiency gains. These benefits may encourage health system investment in such tools.
症状检查器可以通过为患者提供自我服务的分诊建议来帮助满足对 SARS-CoV2(COVID-19)检测和护理的高需求。然而,由于尚未研究这些工具的相关效率提升,医疗系统可能会犹豫不决是否投资于这些工具。我们旨在量化使用在线 COVID-19 症状检查器替代电话热线的相关运营效率提升。
在我们的医疗系统中,门诊患者可以使用在线症状检查器或电话热线进行分诊并获得 COVID-19 护理。我们使用呼叫记录、电子健康记录数据和当地工资对 2021 年 10 月 20 日至 2022 年 1 月 10 日期间使用这两种方法的成年人进行了回顾性分析,以计算劳动力成本。
在总共 15549 例 COVID-19 分诊接触中,1820 例(11.7%)仅使用电话热线,13729 例(88.3%)使用症状检查器。仅 271 例(2%)使用症状检查器的患者还拨打了热线。与涉及症状检查器的接触相比,热线接触需要更多的临床医生时间(17.8 分钟/次与 0.4 分钟/次),导致平均劳动力成本更高(每次接触 24.21 美元与 0.55 美元)。症状检查器节省了超过 4200 个临床医生的工时。
当有选择时,大多数患者在线完成 COVID-19 分诊和就诊安排,从而实现了显著的效率提升。这些益处可能会鼓励医疗系统投资于此类工具。