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PLoS One. 2018 Jun 26;13(6):e0199284. doi: 10.1371/journal.pone.0199284. eCollection 2018.

Self-triage for acute primary care via a smartphone application: Practical, safe and efficient?

Author information

1
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
2
Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.

Abstract

BACKGROUND:

Since 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.

OBJECTIVE:

We 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 SETTING:

A prospective, cross-sectional study amongst app users in a routine primary care setting.

METHODS:

The 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.

RESULTS:

The 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.

CONCLUSION:

The 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.

PMID:
29944708
PMCID:
PMC6019095
DOI:
10.1371/journal.pone.0199284
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

The study was funded by Achmea, a Dutch health insurance company. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development, or marketed products to declare.

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