The contribution of an Automated Triage System to after-hours primary care services in the Netherlands, a pilot study

María Villalobos, Adinda Mailuhu

Keywords: after-hours primary care, urgent primary care, automated triage system, digital health, evidence-based interventions

Background:

The tension to provide better care as efficiently as possible, is strongly experienced by the Dutch primary care. Digital health proponents, portrait these technologies as solutions that will also improve accessibility and provision of care. During the pandemic, primary healthcare providers were pushed to find substitutes to physical contacts and increase their capacity, without increasing human resources. This catalysed the implementation of digital health. An application that is gaining significant attention from primary care providers in the Netherlands, and specifically from after-hours clinics is automated triage systems (ATS). Despite service providers claims, limited independent evidence is available of the effect of ATS in the provision of primary care after hours (urgency primary care).

Research questions:

In this study, a partnership between an after-hours primary care practice and an academic group in the Netherlands, aimed at evaluating the impact of an ATS implemented in parallel to the telephone services during the COVID-19 pandemic.

Method:

For this purpose, we are determining the accuracy of the urgency level assigned by the ATS and the contribution to the traditional telephone service in terms of shifting patients away from other types of care (telephone or in-person), referrals and contacts handled, types of patients seen. This is an observational study with quantitative healthcare data previously collected in the context of regular patient care.

Results:

Preliminary results indicate that urgency levels from telephone contacts differ from the ones assigned by the ATS. From a quadruple aim perspective, this has an impact on the use of resources, the experience of healthcare professionals and patients, and the quality of care.

Conclusions:

This study not only provides evidence of the performance of ATS in a real-world setting, but it is also an example of the practical and methodological challenges of evaluating complex interventions implemented in clinical practice.

Points for discussion:

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