COVID Symptom Checker: Where We Are Now and Where We Are Headed
The COVID Symptom Checker, a self-triage and self-scheduling tool, helped to alleviate the ambulatory surge during the pandemic last year when UCSF staff were inundated with calls while simultaneously managing in-clinic patients.
In his presentation at the 2021 UCSF Telehealth Summit on COVID-inspired Telehealth Advancements, Tim Judson, M.D., Clinical Informatics Lead at UCSF’s Center for Digital Health Innovation (CDHI), talked about the rapid development and deployment of the COVID Symptom Checker, its impact on staff, patients, and what they learned, and where they are headed.
Designed as a self-triage and self-scheduling tool, the symptom checker was not a diagnosis tool. This meant it determined the next step in care and not what condition a patient had. Patients were asked questions about their COVID symptoms, exposures, and risk factors, and then given recommendations on actions they could take. To ensure the success of the tool, they focused on UCSF’s population with its availability to communicate with the EHR.
The team was able to release the symptom checker quickly as they used agile product development followed by iterations to improve upon it. When the symptom checker was initially launched, it only had self-scheduling capabilities for one visit type. But as the pandemic changed, the symptom checker also evolved. For example, when people had symptoms after their vaccination, a disposition was added so that those who were symptomatic didn’t have to come into the clinics or get a test.
The tool also used branching logic and asked follow-up questions based on patients’ answers. For instance, if patients said they had trouble breathing, a question was asked to determine its severity, and then determine next steps.
Other key highlights from Judson’s presentation:
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Since its launch in March 2020, there are now more than 40,000 users, with half of the patients having symptoms, and the other half asking COVID-related questions.
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The symptom checker has helped schedule more than 5,700 direct scheduled appointments.
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All UCSF patients now have access to self-schedule appropriate tests and visit types, and numbers are expected to continue growing.
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The symptom checker is available in English and Spanish.
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A three-month retrospective analysis showed with the COVID symptom checker that patients spent about five minutes on the phone – and sometimes no time at all – versus an average 47 minutes on the hotline.
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The marginal cost is $8.98 for the symptom checker per triage vs. $76.13.
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It is estimated the tool has saved $161,000 over a three-month period (And if self-scheduling functionality was available from its launch, projected savings would be $1.2M).*
Some of the key learnings of the team include the importance of integration and the ability to demonstrate the tool’s feasibility and safety of self-triage and self-scheduling.
Going forward, the team hopes to:
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Better understand clinical outcomes
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Measure patient satisfaction
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Understand and address health disparities
They also want to be able to apply the tool to other situations such as urinary tract infection and respiratory symptoms.
For more information about CDHI digital innovation and solutions, visit www.centerfordigitalhealthinnovation.org.
** Not including development efforts and maintenance costs, extra licensing or contract fees; assumes flex staffing of hotline