Telephone triage, or teletriage, is a service in which health professionals provide support, via telephone, to clients who initiate calls about health concerns. Teletriage is performed by registered nurses or physicians in a variety of settings. The goal of teletriage is to determine the level of care required by the caller and to discuss the options and urgency for care. Depending on the assessment information obtained, options for the caller may be self-care or informal care; a routine visit to a practitioner; an immediate visit to the emergency department or urgent care clinic; or dispatch of an ambulance.
The use of teletriage is evolving. Even though little is known about the clinical or cost effectiveness of teletriage, the number of these programs is expanding.
To evaluate the effects of teletriage services on health service use, caller safety, satisfaction and health-related quality of life
To examine the costs and cost-effectiveness of teletriage services
To summarize the characteristics of Canadian teletriage programs and their evaluations.
A systematic literature review was used to address the first two objectives. Selected studies were assessed using a standard screening tool. To gather data on teletriage in Canada, the Canadian Coordinating Office for Health Technology Assessment surveyed programs funded by provincial and territorial governments.
About 50% of calls to teletriage services can be managed without having to refer the caller elsewhere.
Teletriage reduces the number of immediate visits to physicians without causing adverse outcomes such as subsequent hospitalizations, visits to the emergency departments or deaths.
Two studies – one in the US and one in the UK – show cost savings as a result of nurse teletriage services that are provided outside usual business hours.
Seven Canadian jurisdictions have province-wide teletriage programs (British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and New Brunswick) and the other six have identified a need.
The limited number of evaluations of teletriage programs in Canada show minimal evidence of their clinical impact (e.g. high caller satisfaction, decreased visits to emergency). The cost per call is estimated to be C$10 to C$27 depending on the program.
This summary is based on a comprehensive health technology assessment: Stacey D, Noorani HZ, Fisher A, Robinson D, Joyce J, Pong RW. Telephone triage services: systematic review and a survey of Canadian call centre programs.