Since the pandemic, health suppliers globally are struggling to meet increasing demand. Health systems are overwhelmed, which has thrown into question whether current filtering systems are directing patients to the right level of care.
Filtering – or triaging – patients according to urgency is a critical part of any healthcare provision. It takes on yet more significance in the current climate, when there remains an unprecedented need to avoid all but the most essential use of health services.
Triaging patients into emergency, urgent, non-urgent and self-care categories historically existed in two main guises – in person and over the phone. Now, a new study, published in Journal of Medical Internet Research, has investigated whether digital symptom checkers can streamline this process and help take the strain.
The study, led by Healthily (Your.MD Ltd) and authored by Hai Nguyen, investigated online symptom checkers and their effectiveness in the triage process. The findings suggest that pre-primary care – the point where individuals are considering seeking medical advice but have yet to do so – is where they could be most advantageous.
“Emerging health technologies such as digital symptom checkers are evolving at pace and have the potential to provide a solution to overstretched triage by supporting the initial assessment of individuals presenting with symptoms. AI chatbots can ensure individuals access the right area of the health system with the appropriate degree of urgency,” says Prof Maureen Baker CBE, Healthily Chief Medical Officer.
All forms of assessing patients’ needs have limitations. Triage errors are a major concern in healthcare as they can cause harmful delays in treatments or inappropriate allocation of resources.
“The study highlighted research from Belgium, which compared the health assessment decisions made by telephone operators with those made by physicians. It showed the correctness of the advice given by the operator (according to the physicians) was 71%, with 12% underestimation of urgency and 17% overestimation ,” says Prof Baker.
“In emergency department settings, triage error rates appear to be markedly higher – around 60%, with about 23% of cases under triaged .”
The research points out, however, that studies investigating triage errors are scarce and can’t be wholly relied on. They don’t consider the same number and type of conditions, making it difficult to comprehensively assess the accuracy of each method and there is not always a gold standard final correct diagnosis to compare to.
AI forms of consultation and triage save time. They can provide detailed and accurate recommendations to enable individuals to manage their medical problems themselves, or direct them to appropriate services.
The role of an online health checker is to rate how serious a symptom looks for that person in the light of other aggregated factors and tell those who need it to seek treatment immediately. This can be nothing but helpful for over-stretched triage systems.
The study found that although online symptom checkers are not a superior alternative to seeing a doctor, if used to gather quick and accessible information about particular conditions, they are superior to asking ‘Dr Google’ in self-directed internet searches.  It also concluded that digital symptom checkers are an effective addition – and a safer alternative – to existing sources of health information before individuals visit a doctor.
Independent studies carried out by Academics at Imperial College London’s Self-Care Academic Research Unit (SCARU), show that the Healthily Smart Symptom Checker is safe in more than 9 out of 10 cases. It was found to be ‘working at a safe level of probable risk’ and it got the correct triage 62% of the time and the correct condition 61% of the time.
“As the Imperial College study suggests, there is a big variability between AI symptom checkers, and people should research the symptom checker they chose to use carefully to ensure it’s evidence based and safe,” says Prof Baker. “Online checkers are developing very quickly and with small modifications to this emerging tech, huge healthcare improvements could be felt.”
Ultimately more robust evidence collection is needed. There is currently no clear standard of comparison for triage errors meaning the true effectiveness of digital symptom checkers can’t be assessed, and it’s not possible to make recommendations on an acceptable error rate.
As Healthily CEO Matteo Berlucchi said more than two years ago, “we need a global standard for self-assessment tools, an evidence base that can’t be disputed and gives people confidence that the words in your palm can be relied upon as much as the words spoken in the consultation room.”
Prof Baker concludes: *“We agree with the findings of the report that current triage studies have too many biases to form the basis of an accurate assessment of digital symptom checkers and suggest we need to rethink the standard of testing. Well-conducted research to understand the clinical effectiveness of digital symptom checkers in effectively triaging individuals is urgently needed.
“The routine use of safe and accurate online symptom checkers has the potential to make safe self-care accessible for all, empower individuals to seek the right level of support and help us work towards improved patient care, system efficiency and reduced human error.”*
Healthily is the first AI healthcare platform to put self-care at the heart of healthcare, with a mix of user-friendly health tools, an award-winning app and an AI Smart Symptom Checker, one of the most accurate and advanced symptoms checkers in the world.
As the first self-care platform self-certified as a Class 1 Medical Device in the UK, Healthily helps anyone, anywhere decide when to see a doctor and how to manage wellbeing safely at home.
If you’re interested in helping your users navigate their own health needs with digital content, health technology or AI symptom checking, we’d love to hear from you.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.