TriageLogic News

TriageLogic was again featured in the Section on Telephone Care Newsletter (published by the American Academy of Pediatrics). Click here to download >>>

Andrew R. Hertz, MD, writes in the American Academy of Pediatrics, about TriageLogic's Office Solution that has the potential to lead to significant change in the practice of telephone triage. TriageLogic Office Solution uses a computerized documentation system that not only documents the nurse's assessments, but also the guideline used and specific advice given.

TriageLogic was recently featured in the Section on Telephone Care Newsletter (published by the American Academy of Pediatrics). Click here to download >>>

In this article published in the American Academy of Pediatrics, Andrew R. Hertz, MD, writes about the “innovative telephone triage software company,” TriageLogic. Hertz briefly outlines the “hover” technology of the program. When a nurse wants to view details related to a case, the information immediately appears on the screen. If he or she decides to use any of the information, it is printed out on a triage document. Hertz praises the software for allowing nurses to complete the whole process in one computer screen, avoiding the hassle of clicking through multiple screens. Hertz states that “nurse satisfaction and productivity are likely to increase” with this cutting-edge program. He says that while TriageLogic is similar to other triage software, the “efficient” and “colorful” screens “contain many risk management tools not found in comparable products.”

Triage Related Articles

The cost-effectiveness of a telephone-based nurse triage service as determined by assessing changes in medical service utilization.
http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102234357.html

PRINCIPAL FINDINGS: Implementation of the telephone-based nurse triage service significantly lowered utilization of hospital emergency department and outpatient physician services at the health plan. Emergency room utilization decreased by 15 percent and physician office utilization decreased by 11 percent. The decreases in medical utilization rates during the post-implementation period are even greater when health status is accounted for in the analysis using the ACG Case-Mix Adjustment System. In this study the service is found to be cost-effective in that health plan savings associated with the changes in medical service utilization are greater than the direct and indirect costs of providing the service. CONCLUSIONS: A telephone-based nurse triage service provides quick access to medical advice. The findings of this study suggest that implementation of such a service is cost-effective in that it reduces utilization of hospital emergency department and outpatient physician services. Implementation of the service appears to improve access to medical care while reducing health plan costs.

Reducing Inappropriate Emergency Room Use among Medicaid Recipients By Linking Them to a Regular Source of Care
http://www.clinicians.org/advocacy/ER%20Reduction%20Proposal%20-%20FINAL%208.25.05.pdf

As another example of the benefits of a medical home, a Medicaid managed care plan in Ohio implemented a multi-faceted ‘medical homes’ initiative in 2003. Among other features, the plan established a 24-hour, 7-day Nurse Triage Line to engage in symptom-based triage and to direct enrollees to the appropriate care setting for their condition. In the first 18 months of operation, the Nurse Triage Line alone was able to divert 58% of 13,000 callers away from the ER to a more appropriate level of care, resulting in a net savings of over $1.7 million.

Emergency Department Utilization: Trends and Management
http://www.thci.org/other_resources/topic1112_01.htm

Triage and telephone services: Patients may refrain from seeking care in the ER beyond normal practice hours if they can receive assistance through other means. A growing number of managed care organizations, delivery systems and practices are offering phone consultation with medical personnel 24 hours a day. Patients with questions ranging from how to treat a fever to reducing nausea can often receive advice over the phone from physicians, nurses or other professionals. For the patient, this helps to avoid the cost and lengthy wait time of an ER visit. Some studies on the effectiveness of telephone-based nurse triage services have found a 90% or greater patient satisfaction rating (O'Connell et al, 2001; Wahlberg AC et al, 1999) and a return of a $1.70 in reduced ER and physician office visits for every $1.00 invested in this service (O'Connell et al, 2001).

After-Hours Telephone Coverage: The Application of an Area-Wide Telephone Triage and Advice System for Pediatric Practices
http://pediatrics.aappublications.org/cgi/content/abstract/92/5/670

Results. In 4 years, 107 938 calls have been successfully managed without an adverse clinical outcome. Minor errors in using protocols occurred in one call out of 1450 after-hours calls. After-hours phone calls necessitated an after-hours patient visit 20% of the time and generated one after-hours hospital admission out of every 88 calls. Just over half of the patients were managed with home care advice only, and 28% were given home care advice after-hours and seen the next day in the primary physician's office. Of all patients directed by the telephone triage nurses to be seen after hours, 78% were determined to have a condition necessitating after-hours care. Data are presented regarding call volumes by time of day, day of week, patient age, and patient's initial complaint. The 6 most common complaints accounted for more than one half of the calls, and 38 complaints accounted for more than 95% of all after-hours calls. Utilization by subscribing physicians is described. Satisfaction among subscribing pediatricians was 100%, and among parents was 96% to 99% on a variety of issues. The total cost to participating Denver pediatricians (which includes revenues "given up" as a result of not seeing patients after hours) ranged from 1% to 12% of their annual net income, depending on a variety of factors.

Pediatric Telephone Call Centers:
How Do They Affect Health Care Use and Costs?
http://pediatrics.aappublications.org/cgi/content/abstract/119/2/e305

RESULTS. The response rate for the survey was 77.8% (N = 8980). Parents reported that they would have (1) gone to an emergency department or urgent care facility (46%), (2) treated the child at home (21%), (3) called a physician's office the next day (12%), (4) asked another person for advice (13%), (5) consulted a written source (2%), or (6) other (7%). Of the 46% of callers who would have sought emergent care, only 13.5% subsequently were given an urgent disposition by the call center. Fifteen percent of cases in which the parents would have stayed at home were given an urgent disposition by nurses. Assuming that all callers followed the advice provided, the estimated savings per call, based on local costs, was $42.61 per call. Savings based on Medical Expenditure Panel Survey national payment data were $56.26 per call.

CONCLUSIONS. Two thirds of the cases in which parents reported initial intent to go to an emergency department or urgent care facility were not deemed urgent by the call center, whereas 15% of calls from parents who intended to stay home were deemed urgent. If call-center triage recommendations were followed in even half of all cases, then these results would translate into substantial cost savings for the health care system.