Thought leadership
Our healthcare system is overburdened by COVID-19 self-assessments. Fixing it could take less than a day.
Long before COVID-19, self-triaging tools were available for patients to medically self-assess themselves, perceived as a way to provide an efficient assessment of urgency and the appropriate type of care.
However, there is a problem in which the majority of most symptom-checkers and triage tools operate: They ask patients a series of definitive questions and get back to them with little insight into their possible condition, and in many cases, they are even prone to giving patients the wrong triage advice. Additionally, they don’t provide any further assistance after the patient’s assessment.
This means that assessment tools are failing to incorporate that particular impeccable personalized healthcare solution that we as patients so desperately crave from a physical appointment. In short the assessment tools lack the intelligence component that human interactions naturally encompass and are not able to utilise past patient information to improve themselves and thereby they keep on making the same mistakes over and over again.
In 2015, Havard Medical School assessed 23 symptom checkers and concluded that self-triage tool performance varies greatly depending on the urgency of the condition and how risk-averse these tools tend to be. In cases where self-care was necessary, appropriate triage advice was only given at 33% of the time.
In two-thirds of the cases, medical attention was not necessary, but the symptom checkers still encouraged the patient to seek medical assistance.
And this is not the first time that research is showcasing such results.
In 2019 another research study by the University of Sheffield concluded that algorithm-based triage tends to be more risk-averse than health professionals.
The instant gratification of receiving a second opinion can have many beneficial side effects and might help alleviate the stress that healthcare professionals face, but there’s a fatal flaw in many triage systems, particularly privatized ones: Every private self-assessment tool can promise the moon, but they never take any liability.
Those organizations have risk-averse chatbots that are more likely to encourage a patient to contact a health professional than to ask low- to mid-risk patients to stay calm and commit to self-care.
In the midst of a pandemic, low- to mid-risk patients will feel an even stronger need for confirmation bias by a health professional. Especially as most people never receive an explanation of how these tools came to a conclusion and due to the constant tendency to push the responsibility on to the healthcare sector.
But isn’t it better that people seek professional help than never act at all?
Yes, it is. For mid- to high-risk patients.
But when symptom-free patients go for unnecessary medical check-ups during a pandemic, a system that is already facing severe stress and scarce resources suffers even more.
Nevertheless, self-triaging has continued to be pushed on society during COVID-19.
There’s plenty of research backing the potentially harmful consequences of self-triaging and we can find many examples of how this solution can and should change.
We see three key elements that make a trustworthy foundation for a self-assessment tool
- It has to be based on an integrated protocol owned by authorities
Only when we integrate protocols owned by healthcare authorities, we can allow for a more credible and trustworthy tool for citizens to use.
Protocols and guidelines, provide medical professionals with a set of tools developed to guide the medic’s decision-making process around patients and care. Protocols can vary between different regions and therefore affect patients differently depending on their location.
This means that each self-assessment tool must respect the protocols set out by each healthcare authority.
Harvard Medical School concluded that doctors were making a correct diagnosis over twice as often as online symptom-checkers, and if these doctors are the ones working with symptom-checker and triage tools, they have a higher probability in contributing information that can result in a tool much more capable of giving patients the appropriate advice.
Naturally, this can result in a less risk-averse system. Because if medical professionals, who have proven to have a higher accuracy rate than self-assessment tools, have a say in when a patient should either call emergency services or seek professional help, they can reduce unnecessary patient encounters with emergency medical-services or departments.
Advanced self-assessment tools can assist with keeping all protocols and recommendations frequently updated and on-par with what the latest healthcare recommendations are.
2. Questioning has to run over multiple days, not just a single point in time.
How can we make sure self-triaging tools are not under-triaging or over-triaging?
Both can cause either an increased strain on our healthcare systems or an increase in patient fatalities.
More patient information accumulated from self-triaging tools can provide our healthcare systems with the resources to operate more efficiently and give us the best treatment possible. When we integrate more advanced technology into our self-assessment tools, we’re able to feed the tool with continuously updated information, making the tool more equipped to help triage us as days pass by. These insights from patients and healthcare systems will allow for a more personalized and informative medical experience for the patient.
This is especially important when we think about the fact that self-checkers tend to be overly risk-averse.
If we can have a more advanced self-assessment tool run over a long period of time, we can begin tracking if we’re actually putting more strain on our healthcare systems, or if we’re not triaging our patients enough. This will be immediately flagged and the system will continuously adapt. We can do this by working closely with patients and healthcare authorities, always keeping track of each patient and healthcare professional.
3. It has to encompass intelligence to find a clear pattern from a noisy world.
Currently, self-triaging systems are not working interactively with patients and do not automatically follow up with low- to mid-risk patients.
This is a major problem for us.
Whether it is the hypochondriac patient that is certain that she/he needs medical assistance during COVID-19 or the patient that is completely relaxed after being diagnosed as ‘symptom-free’, all patients should be given frequent and up-to-date information while being regularly checked-up on.
In a world surrounded by more noise than reason, they will not feel cared for, nor convinced that their self-assessment conclusion was correct.
We are building a self-assessment tool that automatically follows up with patients, every morning, asking the necessary questions repetitively, and evaluating whether the situation is deteriorating. If that is the case, the tool will be able to either tell the patient to seek medical help or notify a healthcare professional.
This creates an improved, real-world view of the patient’s situation, creating security and providing healthcare professionals with the necessary information to treat patients when experiencing major health changes.
We need more than simple self-assessment tools.
Even before this pandemic, hospital systems were strained due to a lack of resources and manpower. Self-triaging tools can absolutely make a difference, but only if we build them correctly.
The human touch is vital when we receive medical treatment, and it will never be possible to fully replace that with technology. However, we can enhance our experiences by offering the healthcare sector the best support. We just have to offer them the appropriate tools.
If we can find a silver lining somewhere in this crisis, it is that hopefully, this pandemic shows us how important it is for our healthcare systems to benefit from first-in-class intelligent technological tools.
Our mission is to reduce the stress that patients and the healthcare industry face, by integrating not only a self-triaging solution on its own but one that is integrated into the entire medical system, making sure that no unnecessary visits to doctors are made, while also making sure that mid- to high-risk patients receive the care needed.
Through integrating AI combined with recommended protocols from governments into our COVID-19 solutions, such as self-triaging, we are capable of offering healthcare systems with an optimal solution, therefore paving the way for self-assessments to actually make a difference.
We have to do more, because healthcare professionals deserve more.