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Impact of a Prototype Combining Recommender Functionality With Structured Documentation on Operator Performance in
Siri-Linn Schmidt Fotland1,2, Arngeir Berge1,3, Erik Zakariassen1,2,4
1National Centre for Emergency Primary Health Care, Health and Social Sciences, NORCE Research AS, Bergen, Norway.
JMIR Formative Research
|May 7, 2026
Summary
This study found that an AI-powered prototype modestly improved medical quality in telephone triage but did not change communication quality. Aspects of the interaction were negatively affected, requiring further development before real-world implementation.
Area of Science:
- Medical Communication
- Artificial Intelligence in Healthcare
- Decision Support Systems
Background:
- Traditional medical communication center management relies on operator judgment.
- Rigid decision support systems can hinder effective communication and documentation.
- Recommender systems offer potential for guided decision-making without compromising autonomy.
Purpose of the Study:
- To evaluate the influence of an AI-based question recommendation and structured documentation prototype on telephone triage operators' performance.
- To test the hypothesis that the prototype would enhance medical quality without negatively impacting communication quality.
Main Methods:
- A quasi-experimental pre- and posttest feasibility study in a simulated Norwegian medical communication center.
- 22 operators completed 15 standardized medical cases pre- and post-prototype implementation over 5 months.
- Call audio recordings were assessed using the Assessment of Quality in Telephone Triage tool.
Main Results:
- Overall medical quality showed a statistically significant, albeit small, improvement (mean 6.83 to 7.16, P=.004).
- Overall communication quality remained unchanged (mean 7.06 to 6.97, P=.35).
- Specific communication aspects, such as information collection and clarity of triage decisions, significantly decreased.
Conclusions:
- The AI-powered prototype demonstrated a modest improvement in medical quality in a simulated environment.
- While overall communication quality was unaffected, certain interaction elements were negatively impacted.
- Further development and testing are necessary before implementing AI-driven decision support in real-world telephone triage.
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