Medical Call Center Benchmarking Report: 2004 to 2016. An analysis of 6.5 million triage calls from 16 medical call centers.

Authors:

David A. Thompson 1

1 Northwestern University, Northwestern University Feinberg School of Medicine

Introduction: This report is the 10th in a series of benchmarking studies spanning the years from 2004 to the present (2016). The total telehealth triage encounter volume for the 16 participating medical call centers during this period was 6,564,312 patients.

Methods: All patients triaged during calendar year 2016, using a single nationally available after-hours telehealth triage decision support system, were eligible for inclusion. Triage nurses select the most appropriate triage guidelines based on the patient’s primary reason for call (main problem or symptom). Guidelines selected were frequency ranked for both pediatric and adult encounters. For the purpose of analysis, the disposition levels were consolidated into six primary groups: from the 2023 calendar year. A standardized data entry form was provided, listing 37 possible triage disposition levels. For the purpose of analysis, the disposition levels were consolidated into six primary groups:

1.      EMS 911

2.      Emergent (Go to ED Now, Go to ED/UCC)

3.      Urgent (See Within 4 Hours)

4.      Office Visit (See PCP Within 24 Hours, See PCP Within 3 Days, See PCP within 2 Weeks)

5.      Home Care (Self Care)

6.      Other (all other encounters including L&D, Call Local Agency, Call PCP, See Dentist)

Encounters with dispositions of Duplicate Contact Calls or No Contact Calls were excluded. The participating call centers ran three standardized reports to generate data for the 2016 benchmarking data set. There were no patient identifiers (personal health information) in these reports.

Results: The data set for calendar year 2016 consisted of 592,295 patients from 8 participating medical call centers. There were 309,568 adult patients (defined as age 21 years and older) and 283,137 pediatric patients (less than 21 years old).

The top 20 adult telehealth triage guidelines for 2016 cumulatively were used in 46% of all adult encounters. The top 5 adult guidelines were Medication Question Call, Chest Pain, Sore Throat, Vaginal Bleeding, and Vomiting. The top 20 pediatric telehealth triage guidelines for 2016 cumulatively were used in 55% of all pediatric encounters. The top 5 pediatric guidelines were Cough, Colds, Vomiting Without Diarrhea, Fever - 3 Months or Older, and Diarrhea.

The call center median disposition rates by disposition grouping for adult and pediatric encounters respectively were EMS 911 (3.1%, 0.8%), Emergent (20.6%, 17.5%), Urgent (14.2%, 6.8%), Office Visit (27.1%, 27.3%), Home Care 19.4%, 38.1%), and Other (11.9%, 8.1%). 

Conclusion: Results are presented showing the top 20 adult and pediatric telehealth triage guidelines and median call center disposition rates.

Attribution: The authors are grateful to LVM Systems (https://lvmsystems.com/) for their assistance in creating the reports that were used by participating call centers.

Citation: Medical Call Center Benchmarking Report: 2004 to 2016. An analysis of 6.5 million triage calls from 16 medical call centers. Full report available to participating call centers. 2017.

Related References

Marks GA, Thompson DA.  Top 25 Adult and Pediatric Office-Hours Telehealth Triage Guidelines Used During Calendar Years 2020 – 2022. Abstract and Charts.

Thompson DA, Feirer J. Trends in Emergency Department Visits and Hospital Deaths During the COVID-19 Pandemic: A Comparative Analysis of CDC and Telehealth Call Center Data. September 15, 2023. Abstract and Charts.