Remote patient triage: Shifting toward safer telehealth practice

Abstract

Telehealth is a tool used to diagnose and treat patients at a distance. Telehealth quickly became essential during the COVID-19 pandemic as a result of stay-at-home orders. Regulatory waivers encouraged the use of telehealth as an alternative to the in-person encounter to limit the spread of disease. The pandemic incited a rapid growth in telehealth, and new legislation, new technologies, and providers new to virtual care changed the delivery of traditional telehealth. Postpandemic planning is necessary to support the safe integration of telehealth in the health care system. The purpose of this article is to discuss the current issues affecting telehealth and offer recommendations for safer virtual care. Critical considerations, beginning with an assessment of remote patient acuity, are needed to ensure the standard of care for telehealth is equivalent to the in-person setting. A triage protocol to screen patients seeking virtual services is required to prevent underestimation of severity of illness, sort patients to place of service, and determine if a need exists to escalate to an in-person evaluation or higher level of care. A standard approach to triage may minimize the risks to patient safety and support the appropriate use of telehealth technologies.

Strategies to support maternal and early childhood wellness: insight from parent and provider qualitative interviews during the COVID-19 pandemic

“…Two, HCP participants recommended a system to prioritise and triage patients to in-person or virtual care. Referring to telehealth in general, given the pandemic, others have also recommended that a standardised triage protocol be developed to assess acuity and prevent underestimation of illness severity, sort patients to place of service and determine if there is a need to escalate to an in-person evaluation or higher level of care 20. Three, parent participants recommended being provided or referred to credible educational material because they hesitated to contact HCPs due to messaging about the overburdened healthcare system, and as a result, said they spent a lot of time on fruitless searches for information.…”

Exploring Multiple Dimensions of Access to and Preferences for Telehealth Use

“…Different academic and professional groups are currently attempting to delineate protocols for when telehealth is appropriate. 36–39 …”

A nurse practitioner–led telehealth protocol to improve diabetes outcomes in primary care

“…Month 3 visit was concluded with the completion of the Telehealth Usability Questionnaire (TUQ) satisfaction survey. The TUQ is an instrument that consists of 21 questions on a scale of 1 ( disagree ) to 7 ( agree ) and was developed to measure quality, usability, and satisfaction for both the clinician and the patient (Parmanto et al, 2016).…”

“…Federal COVID-19 waivers and regulatory changes enabled providers to expand the use of TH (CDC, 2020a,b; Center for Medicare and Medicaid Services [CMS], 2021). The rapid changes in regulations and reimbursement policies aided in the feasibility of TH as a modality to enhance patient-provider connectivity (CMS, 2021;Kobeissi & Ruppert, 2021). The pandemic and the regulatory changes created an ideal environment for TH utilization to reduce the risk for exposure without compromising necessary patient care.…”