Patient triage system for supporting the operation of dispatch centres and rescue teams

Abstract

Background: The Thai medical application for patient triage, namely Triagist, is an mHealth application designed to support the pre-hospital process. However, since the functions of the application that are necessary for the pre-hospital process have been found not to be fully developed, the addition of a back-end system has been considered to increase its performance and usability.

Objective: To determine the ability of the previous version to effectively manage the pre-hospital process and analyse the current problems with the pre-hospital operation. Therefore, the new system was developed to support the connection of dispatch centres or operational centres to the Triagist mobile application and system evaluation.

Method: Design thinking methodology was used to analyse, design and develop a patient triage system to support the pre-hospital process in Thailand based on users' requirements. 68 active members of the rescue teams and emergency medical staff in Chiang Mai and Lampang provinces were recruited to test the reliability of the system based on a prototype application.

Results: The new medical mobile application for patient triage in Thailand was validated for use due to containing the two essential functions of Initial Dispatch Code (IDC) geolocation and IDC management. When the system was tested by emergency staff who were responsible for using it, those with the least experience were found to use it better than their highly experienced colleagues. Moreover, in cases where the system had been implemented, it was found to determine the frequency of symptoms, the time period during which cases occurred, and the density of cases in each area.

Conclusion: This system, which has been developed based on the use of smart technology, will play an important role in supporting emergency services in Thailand by enhancing the efficiency of the pre-hospital process. Emergency centres will receive IDC information from the geolocation system so that they can determine patients' location without undue delay. Emergency services will be able to rapidly prepare the necessary resources and administrative tasks will be supported by linking the dispatch centre to central rescue teams.

Keywords: Dispatch centre; Emergency development system; Emergency medical services; Mobile application; Triage.

Fig. 1

Overview of the patient triage system for dispatch centres or rescue teams. Note: The blue arrow indicates the future operation after the Triagist application is accepted for operation with the current Thai EMS.

Fig. 2

Screenshot of the triage geolocation map. The IDC results classified by start date and end date are shown in rectangle A and by patients’ symptoms in rectangle B

Fig. 3

Screenshot of the IDC results list and geolocation information report

Fig. 4

Comparison of the results of users’ feedback that correspond to the usability test criteria [41]. The rating scores are divided into the three groups of medical staff, volunteers and rescue teams. The p-values and standard deviation (S.D.) are presented below the box plots. Labels Q1-Q16 represent each question that corresponds to Table 4. Labels a–e represent the number of years of the sample group’s emergency experience: a 2–3 years, b 3–4 years, c 5–6 years, d 7–8 years, e 9–10 years

Fig. 5

Raw data retrieved from the.CSV file of the patient triage system. Note: some users’ information was omitted from the system to preserve their anonymity

Fig. 6

Data retrieved from the cloud database during September–October 2019 after discarding duplicate and missing information. The numbers in the circles represent the frequency with which cases occur, while the dots in the circles indicate the time they occur, separated into AM and PM. Codes 5, 10, 11, 15 and 22 show that no symptoms were reported in the system in that period