Keith Morse|Nicolai P Ostberg|Veena G. Jones|Albert S. Chan
Use Characteristics and Triage Acuity of a Digital Symptom Checker in a Large Integrated Health System: Population-Based Descriptive Study
Stanford University|Stanford University|Sutter Health|Palo Alto Institute|Sutter Health|Palo Alto Institute
background pressure us health care system increasing due combination aging populations rising health care expenditures recently covid19 pandemic responses pressure hindered part reliance limited supply highly trained health care professionals creating need scalable technological solutions digital symptom checkers artificial intelligencesupported software tools use conversational chatbot format support rapid diagnosis consistent triage covid19 pandemic brought new attention tools due need avoid facetoface contact preserve urgent care capacity however evidencebased deployment chatbots requires understanding user demographics associated triage recommendations generated large general population objective study evaluate user demographics levels triage acuity provided symptom checker chatbot deployed partnership large integrated health system united states methods populationbased descriptive study included webbased symptom assessments completed website patient portal sutter health system 24 hospitals northern california april 24 2019 february 1 2020 user demographics compared relevant us census population data results total 26646 symptom assessments completed study period assessments 1781626646 669 completed female users mean user age 343 years sd 144 years compared median age 373 years general population common initial symptom abdominal pain 206026646 77 substantial number assessments 1235726646 464 completed outside typical physician office hours users advised seek medical care day 729926646 274 within 23 days 630126646 236 quarter assessments indicated high degree urgency 772326646 290 conclusions users symptom checker chatbot broadly representative patient population although skewed toward younger female users triage recommendations comparable nursestaffed telephone triage lines although emergence covid19 increased interest remote medical assessment tools important take evidencebased approach deployment