Video-supported telephone triage in emergency primary healthcare: an observational study from Norway

To describe how video support is used in telephone triage at Norwegian Local Emergency Medical Communication Centres (LEMCs), including frequency, call duration, patterns of video use and associations with urgency and response assessments.

An observational study using national-level operational data and prospectively collected triage data from the Watchtower Project.

Norwegian LEMCs, which provide 24/7 nurse-managed telephone triage within the municipal emergency primary healthcare system, handling a broad range of medical inquiries.

79 LEMCs using the Norwegian Air Ambulance video solution in 2024 and six LEMCs participating in the Watchtower Project in 2022-2023.

Frequency of video use and call duration with and without video support. Video use across caller and patient characteristics and reasons for contact. Changes in urgency level and intended response following video use.

The national-level dataset included 2 242 522 calls and the Watchtower dataset included 109 281 calls. Nationally, video was used in 4.9% of answered calls. Median call duration was 7:13 min (IQR: 5:09-10:02) with video and 3:58 min (IQR: 2:18-6:16) without video (p<0.001). Video was most frequently used in the evening, for children (47% aged 0-15 years), and in calls initiated by next of kin (58%). Skin-related issues accounted for 65% of all video-supported calls. Following video use, urgency changed in 36% of contacts (22% downgraded, 14% upgraded), and the intended response changed in 31%. Changes occurred in both directions, including shifts between nurse-managed and physician-managed responses.

Video-supported calls were longer than non-video calls. Video is used selectively and is associated with bidirectional adjustments in urgency and response assessments in a substantial share of calls.