Clinical call centers (also known as nurse triage and nurse hotlines) are facilities that receive telephone calls from sick individuals or individual seeking advice or appointments.
Clinical call centers capture rich data about a person's illness and they capture this data before a physician encounter. The staff—usually registered nurses—document calls electronically and in real time. They use electronic documentation systems and problem-specific (e.g., fever and cough) charting templates. The nurse (or other call center employee) selects a charting template that is specific to the nature of the call. The choice of charting template itself represents a diagnostic interpretation that is available for analysis.
table 2 8.1 Data Already Discussed in this Book with Chapter References
Notifiable disease reports and laboratory test results 5, 8
Chief complaints (free text) 17,23
ICD codes 23
Over-the-counter medications 22
Internet resources and usage 26
Water quality and water system 9
Air monitoring 19
Charting by template results in detailed data about symptoms that are computer interpretable (not free text). The charting template is often based on a diagnostic/problem management algorithm, which is a tree structure that suggests key facts about the illness (e.g., presence of fever) for the nurse to elicit during the call. The resulting data include the reason for the call, symptoms, severity, date of onset, self-measured temperature of the patient—and a numerical code that corresponds to the template selected by the nurse for documentation of the call (which reflects the nurse's professional judgment). The data also include a time-stamp and the location of the caller.
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