Self-triage for acute primary care via a smartphone application: Practical, safe and efficient?
Self-triage for acute primary care via a smartphone application: Practical, safe and efficient?
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DOI：
10.1371/journal.pone.0199284
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发表时间：
2018-06-26
期刊：
影响因子：
3.7
通讯作者：
van der Velden, Alike W.
中科院分区：
文献类型：
--
作者：
Verzantvoort, Natascha C. M.;Teunis, Teun;van der Velden, Alike W.
BackgroundSince the start of out-of-hours (OOH) primary care clinics, the number of patient consultations has been increasing. Triage plays an important role in patient selection for a consultation, and in providing reassurance and self-management advice.ObjectiveWe aimed to investigate whether the smartphone application "Should I see a doctor?" (in Dutch: "moet ik naar de dokter?") could guide patients in appropriate consultation at OOH clinics by focusing on four topics: 1) app usage, 2) user satisfaction, 3) whether the app provides the correct advice, and 4) whether users intend to follow the advice.Design and settingA prospective, cross-sectional study amongst app users in a routine primary care setting.MethodsThe app is a self-triage tool for acute primary care. A built-in questionnaire asked users about the app's clarity, their satisfaction and whether they intended to follow the app's advice (n = 4456). A convenience sample of users was phoned by a triage nurse (reference standard) to evaluate whether the app's advice corresponded with the outcome of the triage call (n = 126). Suggestions of phoned participants were listed.ResultsThe app was used by patients of all ages, also by parents for their children, and mostly for abdominal pain, skin disorders and cough. 58% of users received the advice to contact the clinic, 34% a self-care advice and 8% to wait-and-see. 65% of users intended to follow the app's advice. The app was rated as 'neutral' to 'very clear' by 87%, and 89% were 'neutral' to 'very satisfied'. In 81% of participants the app's advice corresponded to the triage call outcome, with sensitivity, specificity, positive- and negative predictive values of 84%, 74%, 88% and 67%, respectively.ConclusionThe app "Should I see a doctor?" could be a valuable tool to guide patients in contacting the OOH primary care clinic for acute care. To further improve the app's safety and efficiency, triaging multiple symptoms should be facilitated, and more information should be provided to patients receiving a wait-and-see advice.
