Teletriage nurses often face intense pressure as they work in fast-paced situations while assessing patients, employing critical thinking and delivering high-quality care. This can lead to staff burnout – contributing to an already existing exodus among healthcare professionals.

Adopting automation within teletriage services can make all the difference, according to Stephen Dean, cofounder of Keona Health, a healthcare customer relationship management technology and services vendor.

We interviewed Dean to get an in-depth look at nurse teletriage. We talk about identifying clinical workflow flaws, creating a strategy for improvements, how to implement decision support software and reduce call center pressures, and why AI-automated teletriage can be crucial in supporting patient access.

Q. What is a typical teletriage nurse call like? What contributes to pressure and burnout?

A. Imagine being a nurse tasked with caring for patients. But your hands are cuffed behind your back.

You are not allowed to touch the patient. Then you are blindfolded, so you are not allowed to see them. You have to rely on your ears only and try to understand what they're saying while they are feeling stressed and overwhelmed. This is the practice of nursing for teletriage nurses in terms of clinical responsibilities.

Add to this picture the pressures of a contact center where call volumes are high, you have to work fast, there's pressure to get off the phone, but the patients also need help and guidance. Because the patients are stressed, they sometimes aren't the friendliest.

With these two sources of stress, you can see why nurses would get burned out. With the staffing shortages today, replacing these burned-out nurses is getting harder and harder.

Q. You contend automation can help. On this front, how can identifying clinical workflow flaws and creating a strategy for improvements ease pressure on nurses?

A. A workflow flaw is anything that presents a barrier to patient access and care. Sometimes this is as simple as poor communication skills due to lack of training and support. Usually there is double work because of frustrating redundancies and multiple software systems.

Then there is fractured service. Fractured service is where patients have to be forwarded from one person to another, increasing patient dissatisfaction and delaying care.

Unfortunately, the complexity of healthcare today often forces this. Have you had the experience of telling your story, just to be forwarded to someone else and having to tell your story again? This wastes time and makes us feel unheard. But automation can fix this.

Many healthcare organizations don't have a plan for identifying and resolving these flaws, because they are unaware of what is possible. Even though the exact steps will look different for each organization, there is a universal, four-step process for accomplishing this:

1. Reduce errors and training expenses by creating a very simple standard of flow.
2. Make workflow management easy with modular templates.
3. Remove redundancies with integration.
4. Enable patient self-service and remove nurse busy-work with AI automation.

Q. What role can decision support software play combined with the nurse as the professional caregiver?

A. Decision support software helps nurses in assessing, diagnosing, and giving appropriate and safe case-specific advice. It can greatly improve patient outcomes and deliver higher quality care for busy clinicians.

It is important to emphasize that the goal of decision support software is to aid the nurse to perform higher quality work with less effort. Sometimes when we talk about artificial intelligence, people worry that we mean replacing nurses. This is a big misnomer. AI can help ease staffing pressures, but it will not replace the nurse.

Teletriage nursing is a big job, and decision support software helps make it easier. It's like having a computer helper that has been taught by doctors. This special software has been designed with research-based guidelines.

It helps nurses assess and treat patients in the most efficient way possible. This assistance not only reduces the stress on the nurse, but improves the efficiency of the healthcare system.

Q. You say AI-automated teletriage is crucial in supporting patient access. Please elaborate.

A. AI-automated teletriage uses artificial intelligence to help medical professionals assess and prioritize patient needs. It always includes the type of decision support that we just discussed, but it brings in so much more.

AI-automated teletriage often will include what the industry calls "Patient 360," where the nurse sees a comprehensive view of the patient with real-time patient health data.

This is only half of what it does. Think back to your question about nurse stress. We discussed how the nurse stress comes from two sources. The first source of stress is from trying to deliver clinical service while being handcuffed and blindfolded. Decision support and Patient 360 help with this.

The other source of stress comes from the call center and operations. So much of the work a triage nurse has to do today is not utilizing their trained clinical judgment, but it is busy work. Nurses have to navigate different software systems.

They need to learn not just the tech, but also how to type fast so they can document the phone call. They may be following providers' preferences for on-call escalation or medication directives. There is a tremendous amount of healthcare and call center functions like these that AI is able to automate for the triage nurse.

Nearly every teletriage nurse I know is thrilled with just the idea of reducing their busy work and helping them focus on patients. This is why they got into healthcare in the first place. They want to help people, not become telephone and technology experts. Artificial intelligence helps nurses sustain more fulfilling, fruitful and long-term work.

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Email the writer: bsiwicki@himss.org
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