UCLA Health develops triage process to identify when telehealth is appropriate for care delivery

UCLA Health is creating telehealth-specific triage protocols to help providers determine when it is appropriate to deliver care to patients via a virtual approach, according to a Dec. 30 NEJM Catalyst Innovations in Care Delivery report.

In April and July 2020, UCLA Health surveyed its primary care physicians about how telehealth has affected their ability to deliver appropriate care.

The researchers found that there was a broad agreement among the physicians that the decision to deliver care through telehealth as opposed to in-person should be based on a careful assessment of the risks and benefits associated with each approach. Especially outside of the pandemic, when the risk of visiting a physician's office is very low, the physicians said there are circumstances in which telehealth should not be used, such as for a patient with chest or abdominal pain.

Expanding triage protocols to offer clear guidance on when to deliver care via telehealth can help providers continue to deliver appropriate and high-quality care. Here are three tips from the report's authors for health systems considering a triage-style approach for scheduling virtual visits.

1. Form a multidisciplinary team including clinical, operational and financial stakeholders to analyze and implement changes that increase the system's ability to provide high-quality virtual care.

2. When developing triage protocols, particularly during an active pandemic surge, consider risks associated with both virtual and in-person care. Consult providers, operators and patients to identify red flags to indicate when virtual care is appropriate.

3. Establish performance metrics and collect regular feedback from physicians, staff and patients to continuously improve and refine triage protocols.

The report authors are Daniel Croymans, MD, medical director of quality at UCLA Health; Maria Han, MD, chief quality officer at UCLA Health; and Ian Hurst, law student at University of Virginia.


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