Computer Generated Self-Care Advice via Web-Based Triage of Complaints in Primary Care
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 self-management 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.
Authors: Nijland, Nicol; Cranen, Karlijn; Verlinden, Stef F. F.; Kelders, Saskia M.; Boer, Henk; Gemert-Pijnen, Julia E. W. C. van
Presented @: International Conference on eHealth, Telemedicine, and Social Medicine, eTELEMED 2009.
Award: This paper has been selected as “Best Paper” based on the reviews of the original submission.
About Stef verlinden
After being trained as a physician (University of Leiden, Netherlands), I started in 1994 as a PhD student in a biotech start-up, nowadays called Crucell. My main topic was stem cell gene therapy paralleled by feasibility of viral gene therapy as such.
The small start-up grew rapidly. In 2000 it had 150 employers and went public. By then I was senior scientist, member of the management team and off-track with my thesis. Since being manager was not my ambition and I missed the ‘energy’ of the start-up phase, I decided make another career move, into what we now call e-health.
In 2001 together with 2 brothers, we started our own company. Our goal is the ‘automation’ of processes in healthcare by mean of ICT and the Internet.
Our first ‘product’ is triage/expert systems, which can, fully automated, decide whether you should go see your doctor or that you can take care of it yourself. This works great for of every day complaints like cough, diarrhoea, skin rashes, etc.
Although successful as a stand-alone application, we found out that such systems need to be linked to/ integrated in existing ‘information systems’ in order to
a) get access to the patients medical record and
b) integrate the system into the work process/ workflow of a healthcare provider
So our second product is an information system, which provides semantic interoperability based on international open standards (CEN/ISO 13606/ openEHR).
Since it’s all about the quality of health and healthcare for us citizens, our main focus is on personal health information systems. We do so because we firmly believe that true citizen empowerment starts with control over your own health information and subsequently your healthcare.
Our vision is that citizen empowerment will lead to improved quality of health and healthcare. Equally or even more important it will be a mean to enforce the radical changes required keeping the healthcare system of today of good quality and affordable in the near future.
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