Web-Based Triage in a College Health Setting

Sole, Mary Lou; Stuart, Patricia L.; Deichen, Michael

doi:10.3200/jach.54.5.289-294

Cited by 13 publications

(23 citation statements)

References 5 publications

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“…3 In recent years, there has been increasing interest in online self-triage as a means of supporting self-care and hence more effective help seeking. [4][5][6][7] Previous studies have examined patient and staff attitudes and have found predominantly positive views, 4,6 as well as showing an increased confidence in self-care behaviour. 5 We have evaluated the advice given by a prototype selfassessment triage system in a university student health centre.…”

Section: Introductionmentioning

confidence: 99%

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A study of automated self-assessment in a primary care student health centre setting

et al. 2014

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We evaluated the advice given by a prototype self-assessment triage system in a university student health centre. Students attending the health centre with a new problem used the automated self-assessment system prior to a face-to-face consultation with the general practitioner (GP). The system's rating of urgency was available to the GP, and following the consultation, the GP recorded their own rating of the urgency of the patient's presentation. Full data were available for 154 of the 207 consultations. Perfect agreement, where both the GP and the self-assessment system selected the same category of advice, occurred in 39% of consultations. The association between the GP assessment and the self-assessment rankings of urgency was low but significant (rho = 0.19, P = 0.016). The self-assessment system tended to be risk averse compared to the GP assessments, with advice for more urgent level of care seeking being recommended in 86 consultations (56%) and less urgent advice in only 8 (5%). This difference in assessment of urgency was significant (P < 0.001). The agreement between self-assessed and GP-assessed urgency was not associated with symptom site or socio-demographic characteristics of the user. Although the self-assessment system was more risk averse than the GPs, which resulted in a high proportion of patients being triaged as needing emergency or immediate care, the self-assessment system successfully identified a proportion of patients who were felt by the GP to have a self-limiting condition that did not need a consultation. In its prototype form, the self-assessment system was not a replacement for clinician assessment and further refinement is necessary.

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Section: Introductionmentioning

confidence: 99%

“…University students are a readily-accessible population for evaluating online interventions as they are likely to have good IT access and relevant skills. [4][5][6][7] …”

Section: Introductionmentioning

confidence: 99%

A study of automated self-assessment in a primary care student health centre setting

et al. 2014

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“…Only a minority of people were advised to contact health services, a much smaller proportion than in previous studies of triage for minor symptoms [20,36]. The low rate of advice to use health services could be due to our sample of young, healthy people, who were consulting mainly for minor symptoms, but could also reflect a triage system that had a slightly higher severity threshold for recommending contacting health services.…”

Section: Discussionmentioning

confidence: 80%

“…In addition to being volunteers, our sample mainly comprised students, and web-based advice may prove less appealing and effective in older and less well-educated populations, since they tend to have lower levels of self-efficacy both for web usage and for self-management of health [10,41]. In addition, women were substantially overrepresented in our sample (although the proportion was similar to the take-up observed in an observational study of providing digital triage for a student population [20]). There is evidence that women tend to have a more positive attitude than men toward self-management of health [42].…”

Section: Discussionmentioning

confidence: 81%

“…For example, an observational study of providing a student population with online digital triage advice on whether they needed to seek medical care for minor symptoms was able to demonstrate satisfactory uptake and excellent concordance between the online advice and clinical diagnoses [20]. However, if Internet-delivered care is to become a widely accepted and well-integrated part of efficient routine health care, then we need to understand better how and why it might be welcomed and used effectively [14].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a Web-based Intervention Providing Tailored Advice for Self-management of Minor Respiratory Symptoms: Exploratory Randomized Controlled Trial

Yardley¹,

Joseph²,

Michie³

et al. 2010

J Med Internet Res

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Background There has been relatively little research on the role of web-based support for self-care in the management of minor, acute symptoms, in contrast to the wealth of recent research into Internet interventions to support self-management of long-term conditions.Objective This study was designed as an evaluation of the usage and effects of the “Internet Doctor” website providing tailored advice on self-management of minor respiratory symptoms (eg, cough, sore throat, fever, runny nose), in preparation for a definitive trial of clinical effectiveness. The first aim was to evaluate the effects of using the Internet Doctor webpages on patient enablement and use of health services, to test whether the tailored, theory-based advice provided by the Internet Doctor was superior to providing a static webpage providing the best existing patient information (the control condition). The second aim was to gain an understanding of the processes that might mediate any change in intentions to consult the doctor, by comparing changes in relevant beliefs and illness perceptions in the intervention and control groups, and by analyzing usage of the Internet Doctor webpages and predictors of intention change.Methods Participants (N = 714) completed baseline measures of beliefs about their symptoms and self-care online, and were then automatically randomized to the Internet Doctor or control group. These measures were completed again by 332 participants after 48 hours. Four weeks later, 214 participants completed measures of enablement and health service use.Results The Internet Doctor resulted in higher levels of satisfaction than the control information (mean 6.58 and 5.86, respectively; P = .002) and resulted in higher levels of enablement a month later (median 3 and 2, respectively; P = .03). Understanding of illness improved in the 48 hours following use of the Internet Doctor webpages, whereas it did not improve in the control group (mean change from baseline 0.21 and -0.06, respectively, P = .05). Decline in intentions to consult the doctor between baseline and follow-up was predicted by age (beta = .10, P= .003), believing before accessing the website that consultation was necessary for recovery (beta = .19, P < .001), poor understanding of illness (beta = .11, P = .004), emotional reactions to illness (beta = .15, P <.001), and use of the Diagnostic section of the Internet Doctor website (beta = .09, P = .007).Conclusions Our findings provide initial evidence that tailored web-based advice could help patients self-manage minor symptoms to a greater extent. These findings constitute a sound foundation and rationale for future research. In particular, our study provides the evidence required to justify carrying out much larger trials in representative population samples comparing tailored web-based advice with routine care, to obtain a definitive evaluation of the impact on self-management and health service use.

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Computer Generated Self-Care Advice via Web-Based Triage of Complaints in Primary Care

Nijland

Cranen

Verlinden³

et al. 2009

2009 International Conference on eHealth, Telemedicine, and Social Medicine

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− − − −Computer generated self-care advice systems are used in health care to support self-management and to respond to an increasing demand for care. Web-based triage is an innovative system aimed at empowering patients and saving costs while maintaining the same or better quality of care. Such systems consist of a symptom driven questionnaire for minor ailments based on the criteria: high frequency, no physical contact required to assess medical situation, and the possibility to rule out emergencies. We evaluated the feasibility of such a system for self-care. A retrospective analysis was carried out among 6538 patients by investigating the frequencies of complaints that have been entered to the system and the frequencies of the kinds of generated advice; online surveys (n=192) based on behavioral theories were held to determine factors influencing compliance with generated self-care advice. Web-based triage can promote selfmanagement for minor ailments, especially for patients who have a positive attitude towards computer-generated advice. This positive attitude leads to intentions to follow up the advice and to actual follow up. To reduce unnecessary doctors' visits and to lower health care costs the system has to be brought more in to line with users' needs because the systems are more medical driven than user-centered.

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Web-Based Triage in a College Health Setting

Cited by 13 publications

References 5 publications

A study of automated self-assessment in a primary care student health centre setting

A study of automated self-assessment in a primary care student health centre setting

Evaluation of a Web-based Intervention Providing Tailored Advice for Self-management of Minor Respiratory Symptoms: Exploratory Randomized Controlled Trial

Computer Generated Self-Care Advice via Web-Based Triage of Complaints in Primary Care

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