Pre-hospital delay in patients with myocardial infarction: an observational study in a tertiary care hospital of northern Bangladesh

Rafi, Md. Abdur; Sayeed, Md. Zahidus; Sultana, Papia; Saw, Aik

doi:10.21203/rs.3.rs-15704/v1

Cited by 1 publication

(2 citation statements)

References 25 publications

(51 reference statements)

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“…Improved care acuity alignment through automated triage and accelerated care referral can reduce care delays, a contributor to preventable morbidity/mortality and unnecessary care utilization. [12][13][14][15][16][17][18][19][20][21][22][23] It could also potentially enable a reduction of avoidable care utilization at higher than necessary levels of care acuity, which can help reduce avoidable healthcare over-utilization, and associated avoidable care expenditure or costs. However, an almost equal percentage of patients did not change their care seeking when pre-VT intent was not aligned with the care recommendation generated by VT AI, indicating that AI-based VT must continue its evolution and continuous improvement in how it influences patient-user perception, and how effectively it compels changes in patient care seeking behavior.…”

Section: Discussionmentioning

confidence: 99%

“…The fact that roughly two-thirds of patients who changed their healthcare seeking behavior did so to escalate the acuity of care sought suggests that VT may also have value in earlier detecting and referring conditions which can reduce care delays, and favorably impact patient outcomes and system financial performance. [12][13][14][15][16][17][18][19][20][21][22][23] While it is clinically intuitive that only a handful of patients using VT with a pre-VT intent to visit an ED changed their care seeking to lower acuity care, it is noteworthy that 1.3% of all patients using VT with a non-ED pre-VT intent followed the advice of VT to seek ED care. It appears from this data that few patients with emergency conditions use VT in an ambulatory care setting.…”

Section: Discussionmentioning

confidence: 99%

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Using AI-based virtual triage to improve acuity-level alignment of patient care seeking in an ambulatory care setting

Gellert,

Garber,

Kabat-Karabon

et al. 2024

IJH

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Objective: Evaluate how an AI-based virtual triage (VT) and care referral technology impacted live triage and care referral in an outpatient/ambulatory care network.Methods: Analysis of a dataset of 8,088 outpatient online encounters assessed how VT influenced patient care seeking action/behavior.Results: There were modest decreases in patients seeking outpatient care, including in-person or video face-to-face encounters (-12.5%), or engaging self-care (-8.2%). Patient engagement of virtual care through e-visits and telephone calls increased moderately (19.1%). One-third (35.0%) of patients changed care seeking likely as a result of VT care referral. Another third (32.3%) reported a pre-VT care intent aligned with the VT care recommendation, and a third (32.7%) did not change care sought when their pre-VT intent was not aligned. A total of 12.0% de-escalated acuity of care seeking as recommended by VT, most frequently from outpatient care to virtual care (6.5%) or self-care (4.3%). When VT recommended care de-escalation, 53.5% de-escalated care. In 21.2% care acuity was escalated, of whom 10.6% pursued virtual care and 7.5% pursued outpatient care instead of self-care, while 3.1% whose care intent was virtual care instead pursued outpatient care. When VT recommended care escalation, 96.2% escalated care. Overall, 26.7% of patients required no further action or involvement of clinical staff.Conclusions: Virtual triage impacted patient care seeking action/behavior among almost half of patients whose pre-VT intent differed from the VT recommendation, with patients nearly twice as likely to follow recommendations to seek higher rather than lower levels of care acuity, while modestly reducing the number of face-to-face visits and increasing virtual care. Overall, a quarter of patients using VT were able to perform self-care without interacting with the healthcare team. Virtual triage has the potential to efficiently and effectively redirect patients to more appropriate levels of care.

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