Case Study: COVID-19 Symptom Checker and Triage Tool

• The tool has been used over 100,000 times.

• The symptom checker helped patients self-schedule more than 35,000 appointments.

• The tool was perceived as useful by more than 90% of users.
(March 2020 – 2022)

During the COVID-19 pandemic, UCSF created a COVID-19 hotline and a centralized team to help patients who were seeking information about symptoms and testing. However, this team had trouble keeping up with the high volume of calls, leading to patients having long hold times and difficulty accessing care.

To alleviate this surge, a collaborative UCSF team rapidly developed and deployed a patient-portal based self-triage and self-scheduling tool called the COVID-19 Symptom Checker.

Patients could use this tool to determine their next steps in care based on their symptoms, exposures, and risk factors. The tool is integrated with the Electronic Health Record (EHR) system to ensure its success. It provides patients with 24/7 access to care advice.

Patients are asked a series of questions about their COVID- 19 symptoms, exposures and comorbidities, then the tool provides recommendations for their next steps. If appropriate, the tool allows patients to schedule COVID tests and appointments within a matter of seconds.

• Since its launch in March 2020, the tool has been used over 100,000 times.
• The symptom checker has helped patients self-schedule more than 35,000 appointments.
• The tool was perceived as useful by more than 90% of users.
• All UCSF patients now have access to self-schedule appropriate tests and visit types.
• The symptom checker is available in English and Spanish.
• A three-month retrospective analysis showed:
  •  Only 2% of patients who used the symptom checker also had to call the hotline
  • By giving patients access to self-triage and self-schedule, the tool freed up clinicians who would otherwise have been providing these services over the phone, saving an estimated $161,000 over a three-month period in late 2021.
  • The tool has helped to reduce call times by up to 90%
  • The tool was adopted enterprise-wide for adults and pediatrics, and by a UCSF Affiliate.

Anonymous Feedback from Patients

• "So grateful for the clear, concise setup of your program."
• "Thank you for this tool! Makes life so much easier"
• "This reinforced why I count on UCSF for all my medical needs"
• "This tool is efficient and available 24 hours a day. I don't have to wait for business hours and I don't have to call. Thank You!"

The CDHI team learned the importance being agile and driving toward continuous improvement. When the symptom checker was initially launched, it included self-scheduling capabilities for one visit type, and was only available to a subset of patients. The team worked to overcome technical and operational barriers to make all visit types, including COVID test visits, available to be self-scheduled by all patients.

The team regularly updated the symptom checker as the pandemic evolved. For example, when people had symptoms after their vaccination, a disposition was added so that those patients didn’t have to come into the clinic or get a test.

The team also learned the importance of integration with our Electronic Health Record system. This allowed the encounters in the Symptom Checker to be documented and enabled self-scheduling of tests and visits.

The Symptom checker has been adopted by Epic in its Foundation System and has now been incorporated into the “Schedule an appointment” page within MyChart.