Why Telephone Triage Nurses Are a Perfect Complement to Telemedicine


By Charu Raheja, PhD

Telemedicine has been a medical buzzword for several years, and the variety and depth of services provided have grown dramatically during this time. There is little argument that telemedicine is a great way to supplement traditional medical practices.

The advantages are clear: more convenient care for patients, more doctor availability, less driving time, and less waiting-room time. But like any new evolving field, there is still a learning curve and a need for developing a process that makes telemedicine viable and profitable and doesn’t require doctors to work 24/7 to meet patients’ requests.

One of the biggest hurdles for doctors is that their time with patients is limited. In a traditional office setting, nurses start the patient visit. Nurses take vitals, talk to patients, and evaluate their needs before a doctor walks in the room. The same type of process needs to be designed for telephone medicine, with the difference being that the nurse will do her job over telemedicine, just like the doctor.

Some practices have the nurses in their office taking patient calls and scheduling visits with a doctor. When managing these calls, the nurse needs to perform two tasks. First, the nurse must evaluate whether the patient actually needs the doctor or whether the nurse can help the patient over the phone with home care advice. Second, the nurse must document patient symptom information before making an appointment for the patient to speak with a doctor.

This is where having a good platform to document patient calls and ensure standard protocols comes in. This can ensure patient safety and help make the process efficient. Medical protocols—such as Dr. Schmitt and Dr. Thompson’s protocols—ensure a standard care process every time a nurse takes a call. These protocols are also available electronically, making them easier to use than textbooks. Electronic protocols can also allow the care advice to be documented directly on the patient chart for review by the physician during the telehealth visit.

However, not all doctors offering telehealth services have nurses available to answer patient calls when they first come in. An alternative for these doctors is hiring a telephone nurse triage service. This can serve as an extension of the office by providing patients with a trained nurse to evaluate patient symptoms and determine what actions to take.

What sets a high-quality telephone nurse triage service apart is the ability for the physician to have custom orders and preferences built into the system so the nurses can act as a true extension of the physician. A high-quality nurse triage service is also able to schedule patient appointments when necessary.

Providing patients with access to triage nurses can also be helpful for those doctors who don’t have the ability to provide telehealth services 24/7. If given the appropriate instructions, triage nurses are typically able to resolve over 50 percent of callers’ issues without the need of a doctor.

From a survey of over 35,000 patient phone calls, in over 50 percent of the cases, the nurses were able to resolve the caller’s medical symptoms by giving them home care advice. These nurses were also able to determine which callers required a physical visit to an urgent care or an ER in an event of an emergency (such as symptoms of a potential heart attack).

Telephone nurse triage allows a practice’s telemedicine program to work seamlessly, whether the office is open or closed. Setting up a nurse triage system where nurses use standardized protocols to answer patient questions increases the productivity and profits for a doctor’s practice.

When nurses use triage protocols, physicians can have confidence that they are asking the right questions and not missing anything. The basic patient information, the protocols used, and the nurse notes can also be used as a quick reference for the physician prior to the telehealth visit—similar to the notes doctors receive when their nurses first see a patient during a physical office visit.

Charu Raheja, PhD, is the CEO of TriageLogic a leading provider of quality, affordable triage solutions, including comprehensive after-hours medical call center software, daytime triage protocol software, and nurse triage on call. Customers include both institutional and private practices. If your hospital or practice is looking for information on setting up a nurse triage service, contact TriageLogic to get a quote or set up a demo.