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Implementation of a Self-Triage Web Application for Suspected COVID-19 and Its Impact on Emergency Call Centers: Observational Study.
J Med Internet Res. 2020 11 23; 22(11):e22924.JM

Abstract

BACKGROUND

We developed a self-triage web application for COVID-19 symptoms, which was launched in France in March 2020, when French health authorities recommended all patients with suspected COVID-19 call an emergency phone number.

OBJECTIVE

Our objective was to determine if a self-triage tool could reduce the burden on emergency call centers and help predict increasing burden on hospitals.

METHODS

Users were asked questions about their underlying conditions, sociodemographic status, postal code, and main COVID-19 symptoms. Participants were advised to call an emergency call center if they reported dyspnea or complete loss of appetite for over 24 hours. Data on COVID-19-related calls were collected from 6 emergency call centers and data on COVID-19 hospitalizations were collected from Santé Publique France and the French Ministry of Health. We examined the change in the number of emergency calls before and after the launch of the web application.

RESULTS

From March 17 to April 2, 2020, 735,419 questionnaires were registered in the study area. Of these, 121,370 (16.5%) led to a recommendation to call an emergency center. The peak number of overall questionnaires and of questionnaires leading to a recommendation to call an emergency center were observed on March 22, 2020. In the 17 days preceding the launch of the web application, emergency call centers in the study area registered 66,925 COVID-19-related calls and local hospitals admitted 639 patients for COVID-19; the ratio of emergency calls to hospitalizations for COVID-19 was 104.7 to 1. In the 17 days following the launch of the web application, there were 82,347 emergency calls and 6009 new hospitalizations for COVID-19, a ratio of 13.7 calls to 1 hospitalization (chi-square test: P<.001).

CONCLUSIONS

The self-triage web application launch was followed by a nearly 10-fold increase in COVID-19-related hospitalizations with only a 23% increase in emergency calls. The peak of questionnaire completions preceded the peak of COVID-19-related hospitalizations by 5 days. Although the design of this study does not allow us to conclude that the self-triage tool alone contributed to the alleviation of calls to the emergency call centers, it does suggest that it played a role, and may be used for predicting increasing burden on hospitals.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04331171; https://clinicaltrials.gov/ct2/show/NCT04331171.

Authors+Show Affiliations

Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France. Unité Pasteur-CNAM Risques Infectieux et Emergents (PACRI), Conservatoire National des Arts et Métiers, Paris, France.Service de Maladies Infectieuses et Tropicales, Hôpital Raymond Poincaré, Assistance Publique - Hôpitaux de Paris, Garches, France.Service de Maladies Infectieuses et Réanimation Médicale, Centre Hospitalier Régional et Universitaire Pontchaillou, Rennes, France.Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital and University of Paris, Assistance Publique - Hôpitaux de Paris, Paris, France. Unité, Institut National de la Santé et de la Recherche Médicale, Paris, France.Institut Inter-régional de Cancérologie Jean Bernard, Le Mans, France.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

33147165

Citation

Galmiche, Simon, et al. "Implementation of a Self-Triage Web Application for Suspected COVID-19 and Its Impact On Emergency Call Centers: Observational Study." Journal of Medical Internet Research, vol. 22, no. 11, 2020, pp. e22924.
Galmiche S, Rahbe E, Fontanet A, et al. Implementation of a Self-Triage Web Application for Suspected COVID-19 and Its Impact on Emergency Call Centers: Observational Study. J Med Internet Res. 2020;22(11):e22924.
Galmiche, S., Rahbe, E., Fontanet, A., Dinh, A., Bénézit, F., Lescure, F. X., & Denis, F. (2020). Implementation of a Self-Triage Web Application for Suspected COVID-19 and Its Impact on Emergency Call Centers: Observational Study. Journal of Medical Internet Research, 22(11), e22924. https://doi.org/10.2196/22924
Galmiche S, et al. Implementation of a Self-Triage Web Application for Suspected COVID-19 and Its Impact On Emergency Call Centers: Observational Study. J Med Internet Res. 2020 11 23;22(11):e22924. PubMed PMID: 33147165.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Implementation of a Self-Triage Web Application for Suspected COVID-19 and Its Impact on Emergency Call Centers: Observational Study. AU - Galmiche,Simon, AU - Rahbe,Eve, AU - Fontanet,Arnaud, AU - Dinh,Aurélien, AU - Bénézit,François, AU - Lescure,François-Xavier, AU - Denis,Fabrice, Y1 - 2020/11/23/ PY - 2020/07/27/received PY - 2020/10/21/accepted PY - 2020/08/18/revised PY - 2020/11/5/pubmed PY - 2020/12/2/medline PY - 2020/11/4/entrez KW - COVID-19 KW - application KW - digital health KW - emergency call center KW - emergency medical services KW - mobile phone KW - questionnaires KW - self-triage KW - smartphone KW - website SP - e22924 EP - e22924 JF - Journal of medical Internet research JO - J Med Internet Res VL - 22 IS - 11 N2 - BACKGROUND: We developed a self-triage web application for COVID-19 symptoms, which was launched in France in March 2020, when French health authorities recommended all patients with suspected COVID-19 call an emergency phone number. OBJECTIVE: Our objective was to determine if a self-triage tool could reduce the burden on emergency call centers and help predict increasing burden on hospitals. METHODS: Users were asked questions about their underlying conditions, sociodemographic status, postal code, and main COVID-19 symptoms. Participants were advised to call an emergency call center if they reported dyspnea or complete loss of appetite for over 24 hours. Data on COVID-19-related calls were collected from 6 emergency call centers and data on COVID-19 hospitalizations were collected from Santé Publique France and the French Ministry of Health. We examined the change in the number of emergency calls before and after the launch of the web application. RESULTS: From March 17 to April 2, 2020, 735,419 questionnaires were registered in the study area. Of these, 121,370 (16.5%) led to a recommendation to call an emergency center. The peak number of overall questionnaires and of questionnaires leading to a recommendation to call an emergency center were observed on March 22, 2020. In the 17 days preceding the launch of the web application, emergency call centers in the study area registered 66,925 COVID-19-related calls and local hospitals admitted 639 patients for COVID-19; the ratio of emergency calls to hospitalizations for COVID-19 was 104.7 to 1. In the 17 days following the launch of the web application, there were 82,347 emergency calls and 6009 new hospitalizations for COVID-19, a ratio of 13.7 calls to 1 hospitalization (chi-square test: P<.001). CONCLUSIONS: The self-triage web application launch was followed by a nearly 10-fold increase in COVID-19-related hospitalizations with only a 23% increase in emergency calls. The peak of questionnaire completions preceded the peak of COVID-19-related hospitalizations by 5 days. Although the design of this study does not allow us to conclude that the self-triage tool alone contributed to the alleviation of calls to the emergency call centers, it does suggest that it played a role, and may be used for predicting increasing burden on hospitals. TRIAL REGISTRATION: ClinicalTrials.gov NCT04331171; https://clinicaltrials.gov/ct2/show/NCT04331171. SN - 1438-8871 UR - https://www.unboundmedicine.com/medline/citation/33147165/Implementation_of_a_Self_Triage_Web_Application_for_Suspected_COVID_19_and_Its_Impact_on_Emergency_Call_Centers:_Observational_Study_ DB - PRIME DP - Unbound Medicine ER -