Symptom Checker Drives the RIGHT Virtual Visits

Telemedicine Graphic

The COVID pandemic pushed many healthcare organizations to:

1. Implement new telemedicine services or

2. Expand their existing telemedicine programs

Whether your organization calls it telemedicine, telehealth, video visits or virtual visits, it’s a convenient and affordable service. It enables patients to get care they needed, without being exposed to COVID-19 or other contagious illnesses at an in-person appointment. 40% of consumers surveyed indicated they would continue to use telemedicine going forward.¹

Access to virtual care supported by our customer organizations include:

    • Scheduling in advance with the patient’s own doctor offers a seamless experience when self-scheduling online via personal health portal.
    • On Demand service, typically available 24 hours/365 days per year and staffed to provide service within 60 minutes of the patient’s request (may connect to virtual waiting room)
    • Hybrid services, which often start with a virtual exam and then result in a scheduled in-person visit.

In a recent McKinsey article¹, they named symptom checking (e-triage) as step one of the next chapter of telehealth.

“Integrating e-triage solutions with virtual visits to create a broader “digital front door” for healthcare enables consumers to easily get care when they need it, through the most convenient channels, and lowers the cost of care by avoiding unnecessary ED visits.”

¹ Bestsennyy, Gilbert, Harris, Rost, Telehealth: A quarter-trillion-dollar post-COVID 19 reality? (McKinsey & Company, July 9, 2021).

Symptom Checker Telemedicine Sore Throat Recommendation

How Self Care Decisions (SCD) Supports Your Virtual Services

SCD started working with telemedicine services in 2014. Our symptom checker serves as a useful filter and conduit to your service. The benefits of positioning the symptom checker as a first step are:

    • Helping the user determine IF telemedicine is a proper option, based upon his/her symptoms
    • Directly connecting the user to a web page or mobile app to learn more or begin your virtual process

We manage nearly 300 symptom care guides (170 pediatric; 127 adult) which include a collective set of roughly 6,000 questions or symptom scenarios. With each year’s content update, we have telemedicine physicians review each symptom scenario, answering the conceptual question: If the user has this symptom scenario, would a telemedicine provider be able to safely address the user’s illness or injury?

Can we send it all? No.

Right from the start, there are scenarios that would not be telemedicine appropriate. Examples are:

    • All emergent or life-threatening scenarios (dispositions of Call 911, Go to ER Now)
    • Lower-acuity scenarios in which the user needs a lab test, xray, diagnostic test or in person procedure such as a tetanus shot
    • Any required physical exam that cannot be performed well virtually
    • Scenarios involving genitalia, breasts*

*There is still hesitance for telemedicine programs to address symptoms in “personal areas” – genitals, rectum and breasts – by video. So, most were Null (not appropriate for telemedicine). If these symptoms can be addressed through audio-alone, they were tagged as T1 (audio-only).

“There is a growing generation of patients and parents who prefer the seamless digital experience,” says Bonnie Offit, MD, our Chief Innovation Officer. “Once they know virtual care is available at your organization, they can start with a symptom check (self-triage) to determine what action is needed and connect directly to your virtual services. Furthermore, patients can access our care advice (included with each symptom care guide) to support after-care instructions.”

For the remaining questions, we consider what is the lowest level of technology that could support the visit. These change at times, when new developments occur in the industry, but today there are 5 levels:

  • T1 or audio only. Basically, a provider on a telephone.
  • T2 or store-and-forward (asynchronous) service. In this mode, a patient might complete a medical history (intake) and attach images or videos. The information is sent to a provider who responds with a diagnosis or treatment at a later time.
  • T3 or audio-video, which we think of as the FaceTime experience. Typically, this type of visit is scheduled in advance with one’s own provider or a sponsored service. This is often a same day or next day service.
  • T4 or audio-video AND available On Demand, 24/365 (within 1 hour or less).
  • T5 or audio-video plus data feed (such as digital stethoscope, otoscope, telemetry, etc.). This is less often used with the general public but can be extremely useful for patients with chronic conditions.

The options described to the left are designed to build upon each other. For example, if a question was marked as T1 (can be managed by a phone call), it could also be managed by any higher service, such as T3 – the commonly supported “FaceTime” experience.

Telemedicine Disposition Levels Graphic

From a clinical disposition ( recommended action) perspective.

Symptom Check Disposition Chart