Experiences With Internet Triaging of 9498 Outpatients Daily at the Largest Public Hospital in Taiwan During the COVID-19 Pandemic: Observational Study

Abstract

Background During pandemics, acquiring outpatients’ travel, occupation, contact, and cluster histories is one of the most important measures in assessing the disease risk among incoming patients. Previous means of acquiring this information in the examination room have been insufficient in preventing disease spread. Objective This study aimed to demonstrate the deployment of an automatic system to triage outpatients over the internet. Methods An automatic system was incorporated in the existing web-based appointment system of the hospital and deployed along with its on-site counterpart. Automatic queries to the virtual private network travel and contact history database with each patient’s national ID number were made for each attempt to acquire the patient’s travel and contact histories. Patients with relevant histories were denied registration or entry. Text messages were sent to patients without a relevant history for an expedited route of entry if applicable. Results A total of 127,857 visits were recorded. Among all visits, 91,195 were registered on the internet. In total, 71,816 of them generated text messages for an expedited route of entry. Furthermore, 65 patients had relevant histories, as revealed by the virtual private network database, and were denied registration or entry. Conclusions An automatic triage system to acquire outpatients’ relevant travel and contact histories was deployed rapidly in one of the largest academic medical centers in Taiwan. The updated system successfully denied patients with relevant travel or contact histories entry to the hospital, thus preventing long lines outside the hospital. Further efforts could be made to integrate the system with the electronic medical record system.

Preventing and controlling intra-hospital spread of COVID-19 in Taiwan – Looking back and moving forward

“…These include temperature measurement using non-contact thermal imaging cameras, 34 on-site digital reading the National Health Insurance cards, 35 and automated triage and appointment systems which are incorporated into the hospital's existing web-based appointment system and deployed along with its on-site counterpart to expedite entry into hospitals. 36 Both automated triage and appointment systems query COVID-19 risks (international travel, confirmed cases, close contacts) through web-based database maintained by the National Health Insurance Administration, which integrates data from the Immigration Agency and CDC. Visitors or patients with relevant histories are denied registration or entry; on the other hand, they are referred to either epidemic clinics or outdoor quarantine stations of emergency departments based on their medical needs.…”