The digitalization of emergency department triage: the perspectives of health professionals and patients

Abstract

Background: Digitalization in the healthcare sector offers several organizational advantages, ranging from enhanced service quality to cost savings. However, its adoption often progresses slowly and faces challenges, especially in critical settings like emergency departments, requiring prompt, clear, and efficient communication. As such, this study aims to comprehensively assess the factors influencing the preference for digitalized tools over traditional methods from the perspectives of both service providers and users.

Methods: We employ two ad hoc stated preference surveys in which we ask respondents to reveal their preference in simulated triage scenarios. Three main alternatives are proposed: traditional procedures, a fully digitalized solution with no direct patient-professional interaction, and a hybrid option that combines traditional and digital aspects. Scenarios and alternatives vary according to predetermined attributes, selected among the features acknowledged to impact the triage efficiency and efficacy: the possibility to communicate in a known language, the completeness of information retrieved from the patient, the time dedicated to triage activity, and the level of privacy. Responses are analyzed by means of discrete choice models.

Results: Our findings reveal a preference for the hybrid approach, wherein patients use digital tools to input relevant information, followed by an interview with healthcare professionals. Nevertheless, distinct alternative- and case-specific features can favor the preference toward other kinds of triage. Respondents prefer shorter triage times and the opportunity to interact in a known language, while the level of privacy does not significantly impact their choices. Interestingly, the presence of an algorithm assigning urgency code diminishes the probability that healthcare professionals select the fully digitalized option.

Conclusions: This study provides important insight into the utilization of digital tools in emergency departments. The results can be used by hospital managers and policy makers to develop digital tools that meet the needs of both users and healthcare professionals. This, in turn, may result in cost savings and improved quality of service.

Keywords: Choice modeling; Digital health; Digitalization; Emergency department; Stated preferences; Triage.