Reprinted with permission from Healthcare Contact Center Times
You might not see Dr. Barton Schmitt’s name as an author on The New York Times Best Seller List, but in our industry—he’s a literary megastar. He wrote the first book on pediatric telephone triage in 1980 and since then, he’s written four other integrated sets of clinical content that are used to triage patients. His pediatric nurse telephone triage guidelines are used by almost every nurse triage service in the country.
The Need for a Better Way to Screen Patients
He got inspired to write the guidelines when he was working at the Children’s Hospital Colorado Emergency Department, seeing so many patients who were coming in with medical issues that didn’t need ED-level care.
“I kept thinking to myself, ‘Why am I seeing this patient?’ My grandma could’ve answered this question,” Dr. Schmitt says. “All kids get fevers; all kids get colds; and they didn’t have any complications. There had to be a better way to answer questions that parents were asking. I’m an ex-engineer. I was taught that everything has a process. There’s always a way to make things work better.”
Making things better—tweaking, tinkering and always getting feedback from others—is what led him to create a way for telephone triage nurses across hospitals and pediatric offices to handle calls from patients.
Based on his nurse triage protocols, Dr. Schmitt created a red flag list for schedulers and contact center agents—a one-page PDF that lists high-risk symptoms like stridor, seizure or acting confused. If a caller mentioned one of the symptoms on the list, the scheduler would follow a workflow to prioritize the handling of that call.
Across the country, contact centers have used this list or created their own to post in cubicles or store on computers. Contact center agents are constantly toggling between software systems and these lists to properly handle calls. It can be cumbersome.
From book to a list, something needed to change.
Creating a More Functional Tool
Dr. Schmitt saw an opportunity to partner with ClearTriage and create the SymptomScreen software solution. He spent time with ClearTriage’s computer software engineers to create a layout that non-clinical staff could follow easily. Instead of a one-page list of symptoms saved as a PDF, this is a dynamic, advanced tool with layers that allow schedulers and intake staff to ask more detailed questions, routing patients to the appropriate next step.
Not only can SymptomScreen be embedded into the electronic medical record or other contact center software, but it helps the scheduler find the right guide with a list of synonyms and corrections for misspellings. For example, if a caller says they have “vertigo,” and the scheduler doesn’t understand what that is, SymptomScreen will let the scheduler know it’s a type of dizziness.
SymptomScreen has been out in the market for almost three years and is used every day by thousands of schedulers and other contact center agents. Since its release, Dr. Schmitt and the ClearTriage team have doubled the number of topics and revised the software more than a dozen times.
“It doesn’t replace nurses in any way,” Schmitt says. “This is all about getting the call to the right call queue so the caller talks to the right person at the right time.”
Implementing SymptomScreen: One Organization’s Experience
Variety Care in Oklahoma has used SymptomScreen since it first came out on the market. It’s used there by 40+ contact center agents and by patient service representatives at the clinical site level.
“It’s a really good clinical tool that provides consistency in handing off calls to nurse triage and in scheduling appointments,” says Margaret Holloway, VP of Patient Engagement and Projects at Variety Care’s Patient Access Center. “It takes away the guessing game, which is especially important since our contact center agents aren’t medically trained.”
Plus, Variety Care can customize the tool to their patient population.
“Making changes has been very easy and we can do it in a short amount of time,” says Ana Guzman, Patient Access Specialist Manager at Variety Care. “For example, for our pregnant patients, we used to send them to urgent care, but based on our feedback from our urgent care director, they didn’t have the tools to appropriately assess the pregnant patient. We were able to work with our Women’s Health department to change the screening guides and get these callers to the right place.”
Holloway describes SymptomScreen as a great patient safety tool, training tool and resource.
“It’s very easy to navigate,” Holloway says. “Based on what the patient says, the agent will get a color-coded notification about what action to take next. Green means it’s a regular appointment or nurse triage. Yellow is urgent care, same-day appointment, or nurse triage. Red is high priority nurse triage or the emergency room. SymptomScreen makes it clear to our agents how to direct the patient to the level of care they need.”