Telephone Triage

By Peter DeHaan, Ph.D.

Fall, 2003

Of all the exciting advances in medicine, there is one that falls outside the traditional scope new drugs, innovative procedures, or revealing research.  This development is in the application of telephone technology to facilitate the provision of healthcare.  Lumped into the broad category called telemedicine or telehealth, the telephone is cost-effectively improving patient care while increasing patient satisfaction.  The application of technology to cut costs and improve quality in any industry is noteworthy; in medicine, it is critical.

One of the most exciting developments in telemedicine is telephone or nurse triage.  The history of telephone triage dates back three decades.  For Dr. Barton Schmitt, arguably the father of telephone triage, it was born out of the practical necessity of ensuring consistency and accuracy among those who interacted over the phone with parents concerned about a child's well-being.  His initial telephone protocols have been refined, expanded, and validated for the past 30 years.  More than 400 call centers are using computerized versions of his work and an estimated 10,000 pediatric offices refer to the printed version.  Others have independently developed similar protocols.

Telephone triage will be a reoccurring theme in AnswerStat, as we believe it is an important development, not only for medical related call centers, but also for healthcare as a whole.  Our goal in this issue is to introduce the subject and provide some initial resources.  Look for more information and articles in upcoming issues.

Telephone Triage Call Centers: There are several call centers that provide telephone triage on an outsource basis, or for a fee, to hospitals, clients, individual practices, and medical answering services.  View our current list.

Telephone Triage Vendors: Lastly, here is a list of vendors who have integrated telephone triage protocols into call center software.

Books on Telephone Triage: As a primer for learning more about telephone triage, you might want to refer to some of the many books available on the subject.  Here is a list of some of them (let us know your favorites and we will add them to our list):

• Pediatric Telephone Advice by Barton D. Schmitt (Spiral-bound) 

• Pediatric Telephone Protocols: Office Version by American Academy of Pediatrics, Barton D. Schmitt 

• Quick Reference to Triage by Valerie G. A. Grossman, et al.

• Telephone Health Assessment by Sandra M. Simonsen 

• Telephone Medicine: Triage and Training: A Handbook for Primary Care Health Professionals by Harvey R. Katz, Harvey P. Katz

• Telephone Triage: Theory, Practice, and Protocol Development by Sheila Q. Wheeler, Judith Windt

• Telephone Triage for Obstetrics and Gynecology by Vicki E. Long, Patricia C. McMullen

• Telephone Triage of the Obstetric Patient by Deborah E. Swenson 

• Telephone Triage Protocols for Adult and School Age Populations with Women's Health and Infant/Child Protocols by Sheila Wheeler, RN, MS

• Tele-Nurse by Marijo Baird, Sandi Lafferty 

Additional Resources: In addition to information on the websites of the preceding vendors, also consider:

Call Center Consulting Network: www.3cn.org; 480-706-2226

Carol M Stock and Associates: www.carolstock.com 

TeleTriage Systems: Sheila Wheeler; info@teletriage.com; www.TeleTriage.com

To read other articles written by Peter DeHaan, go to Vital Signs or check out his blog at blog.peterdehaan.com.  In addition to publishing AnswerStat and Connections Magazine, Peter is offers custom publishing and Internet publishing (www.MyArticleArchive.com).  He may be reached at dehaan@answerstat.com or www.PeterDeHaan.com.