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

Area of Science:

• Digital Health
• Primary Care Technology
• Health Informatics

Background:

• Rising patient consultations in out-of-hours (OOH) primary care necessitate efficient patient selection and guidance.
• Triage is crucial for directing patients to appropriate care levels and promoting self-management.

Purpose of the Study:

• To evaluate the smartphone application "Should I see a doctor?" as a tool for guiding patients to OOH primary care.
• To assess app usage, user satisfaction, accuracy of advice, and user adherence to recommendations.

Main Methods:

• A prospective, cross-sectional study involving app users in a primary care setting.
• Utilized a self-triage questionnaire (n=4456) and a nurse triage validation (n=126).

Main Results:

• 58% of users were advised to contact the clinic, 34% self-care, and 8% wait-and-see.
• 87% found the app clear, 89% satisfied; 65% intended to follow advice.
• App advice aligned with nurse triage in 81% of cases (sensitivity 84%, specificity 74%).

Conclusions:

• The "Should I see a doctor?" app shows potential as a valuable tool for directing patients to OOH primary care for acute conditions.
• Enhancements for multiple symptom triaging and clearer "wait-and-see" advice are recommended to improve safety and efficiency.