Automated Triage

By Trevor Smith, MD

Executive Summary

Using a new method of organization, patients will be directed to specific physicians based on their chief complaint, or reason for seeking care, within an automated system to connect them to the appropriate physician specialist. Simultaneously, MedCredits can collect data on physician patterns of referral to be used to further enhance the internal automation and as industry insight to monetize via consultation with the greater healthcare industry.

The Problem

Directed care is the future of medicine. The increasingly complex landscape of the business of medicine and the siloing of medical knowledge has resulted in dramatically subspecialized groups. Some areas, such as neurology, have even developed “hyperspecialists” that treat a single disease process (ex. demyelination: multiple sclerosis, NMO, Guillain barre). Though a doctor may find it to be a natural process to direct a patient to various specialists based off a primary complaint alone (and more so with additional symptoms/signs), it is often impossible for a patient to do so, even with WebMD or Google at their side. Patients do not have the knowledge or experience to know who to see for their medical concern. Additionally, they often do not have the understanding of the medical system to know which physicians to turn to, what order to see them in, or what timing will be most efficient. The value of a solution is therefore very obvious to the patient: identifying pertinent positive and negative features of a clinical history can save them significant time, money, and a disproportionate amount of frustration.

The Solution and its Benefits to MedCredits

Appropriate referrals. When a doctor signs up to see patients and explore the platform they should be set up for success. Directed care allows new physicians to immediately set to work at diagnosing and treating while retaining subspecialists along the way. This will result in increased growth and diversity of medical specialties on the physician token-curated registry (TCR).

Encourage internal referrals. The current method of TCR out-voting may inadvertently result in penalizing onboarded doctors attempting to treat outside their training rather than rewarding them for referring to the appropriate specialty within MedCredits. Instead of risking incorrect diagnoses and having their tokens appropriately voted away, doctors may move off the platform entirely. Alternatively, rewarding them for referrals and collecting the patterns of those referrals would enhance the automated directed care system within MedCredits. Avoiding physician attrition early in the process cannot be emphasized enough. Physicians love to talk negatively about their bad experiences with new technology and they will never forget a company that takes their money for just trying a new method of treating patients.

Faster response. A patient simply wants to get their questions answered and get better as soon as possible. An alert sent to the most appropriate physicians increases patient satisfaction.

This could be implemented using a “Suggested Specialist” component of the consult request form.

Based on your submission, we recommend a dermatologist. They will be the best doctor for your concerns.

Offer a group consultation. A patient could find out right away if they need multiple consultants to diagnose their issue. MedCredits can offer them treatment or assessment by (1) the most likely specialist, (2) a generalist who can direct further for more complex issues, or (3) send them to a group assessment for a higher fee:

Your chronic cough may benefit from assessment by several specialties: ENT, pulmonology, infectious disease, and allergy. Get a group opinion all at once at a reduced rate to rapidly figure out the cause and treat that nagging (chronic) cough!

Leverage available information to build an initial database for patient direction. Doctors will show you how they recommend redirecting consults. However, the many diagnostic websites (WebMD) can be screened for repetition of words or phrases as a starting point for the automated system and later refined by the internal referrals. An application of AI may be helpful here, but at this point a simple word recognition system would be a great place to start and is implementable early on in the platform without significant programing expertise required. In the future, AI and ML developers (i.e. Algorithmia.com) will find a growing market on the MedCredits ecosystem to develop and deploy trustless machine learning contracts to enhance automated triage algorithms. This is significant value for the time and effort.

Use the data. If automated triage and an internal referral system become a successful component of the platform, the data could be used to create value for local, centralized healthcare systems. A local University Hospital, for example, may consider a component of non-concierge medicine that still allows an elevated tier of access and directed care, both to increased access to expert physicians and to save the patient time by sending them to the appropriate subspecialty. They would benefit from consultation with MedCredits regarding our patterns of practice system developed within the MedCredits system.

Opportunities

Automated triage will grow the physician TCR by opening doors and increasing retention of specialists and subspecialists. In addition, the usability of the Hippocrates application will improve to allow patients to quickly and confidently submit healthcare request and concerns. Finally, the referral patterns and the decentralized ontology of healthcare complaints will create a rich and fertile data analytics marketplace for developers, influencers and leaders at all levels of the healthcare ecosystem.