Strategies to Handle Increased Demand in the COVID-19 Crisis a Corona Telephone Hotline and a Web-based Self-triage System

Abstract

BackgroundIn emergencies, such as the COVID-19 pandemic, there is an increased need for contact withemergency medical services (EMS), and call volume might surpass capacity. Thus, the Copenhagen EMS in Denmark implemented a separate coronavirus hotline followed by a web-based self-triage system to reduce nonemergency call volume. The aim of this paper is to present the two measures implemented to handle the increased call volume to the Copenhagen EMSfromthose with mild or no relevant COVID-19 symptoms.MethodsThis is a cross sectional observational study monitoring call volume in the first month of the COVID-19 pandemic in accumulated callnumbers, compared to the equivalent numbers during one month from the year before (2019). A coronavirus hotline and web-based self-triage system arepresented in absolute numbers of users.ResultsIn the first month of the COVID-19 pandemic in Copenhagen, emergency medical dispatch centers were extensively overloaded with more than 10.800 calls, resulting in significantly prolonged queue time (mean time in minutes:12:02; CI: 11:55-12:09)) compared to 2019 (mean time in minutes02:23; CI: 02:22-02:25) and thereby limiting access to emergency assistance and triage for citizens. The introduction of the coronavirus hotline showed reduced call volume and queue time to the EMS. The web-based self-triage system was used more than 107.000 times. However, no correlation between call volume and the use of a web-based self-triage systemwas observed.ConclusionsCreating a coronavirus hotlinestaffed by healthcare personnelseemed to have an impact on call volume and potentially relieved the strain in resources, while the web-based self-triage system was widely used and could be further developed to reach itsfull potential. Other EMS organizations can implement these measures to enhance capacity in a future epidemic.

‘You should see a doctor’, said the robot: Reflections on a digital diagnostic device in a pandemic age

“…Therefore, its concrete content elements have changed over time. With support of their software provider – Microsoft – CEMS designed the device as a simple decision tree ( Figure 1 ) inspired by the decision trees normally used in their telephone assessments of symptoms [ 1 ]. The helplines are the entry point into the primary and secondary health-care services in Denmark outside of regular GP office hours.…”

“… The decision tree of the Danish COVID-19 ‘chatbot’, by the Copenhagen Emergency Medical Services (CEMS). The figure is based on the first version of the launched device and the decision tree published by CEMS elsewhere [ 1 ]. …”

“…Right at the beginning of the COVID-19 pandemic, the Copenhagen Emergency Medical Services (CEMS) developed a digital diagnostic device to assess symptoms of infection [ 1 ]. In just three days, this device was launched in the Capital Region of Denmark.…”

“…A week later, the device was implemented nationwide in Denmark and was used more than 90,000 times in its first week and almost 150,000 times in the second week. The purpose of the device was presented as twofold [ 1 – 4 ]: (a) to help individual citizens in assessing whether symptoms they experienced were potentially COVID-19 related and to advise them when and where to seek further medical assistance; and (b) to reduce the number of calls to public health-care helplines. Immediately, politicians and administrators described this digital diagnostic device in press releases as ‘a new digital solution from the Regions’, which ‘has been a great success’ [ 4 , 5 ].…”

Internet of Things Based Flexible Architectures for Public Distribution System in Lockdown Situations

“…One can argue that if the affected person cannot afford the smartphone, one could instead establish a telephone helpline. However, recent research [13] shows that while taking the example of Copenhagen's emergency medical dispatch centers, they were extensively overloaded with more than 10800 calls, resulting in significantly prolonged queue time. Since India's population is more than 200 times Denmark's population, one can imagine the massive number of requests any situation will generate, making the telephone helpline way of handling the PDS impractical.…”