24/7 Nurse Triage vs AI: Enhancing Ambulatory Care, Shielding Against Under-Triage

Dominique Wells, MSN, RN

Three out of four patients don’t trust the use of AI in healthcare settings, especially when they fear it’s being used as a replacement for human decision-making. Yet organizations increasingly rely solely on AI-powered technologies to assess whether patients have urgent care needs — and this can have a detrimental impact on patient trust.

“Tele-triage” technologies like interactive voice response (IVR) and robotic process automation (RPA), which are forms of AI, have become go-to tools for improving patient access in ambulatory care settings. They are even being explored as a way to facilitate member engagement.

But these systems only work when they are designed with the user’s needs and preferences in mind. IVR for prescription refills, for example, offers value for patients and providers because it eliminates cumbersome manual processes that delay getting needed medication. Patients also are receptive to the use of automated technology for scheduling follow-up appointments because it’s an area where one-to-one connection typically isn’t needed. When patients do need live assistance, options to bypass the automated system exist, a crucial component for maintaining satisfaction.

A patient who calls a community line or their provider after hours doesn’t want to navigate an automated system when they need care advice in the moment. It delays them from their goal: getting an answer that only a medical professional can provide. That’s why a 24/7 model for nurse triage — one that combines IVR or RPA gateways with the option to speak with a nurse in real time — is crucial to delivering positive patient experiences and better health outcomes.

The desire for a more personal touch

Amid seasonal outbreaks of respiratory illnesses like COVID-19 and RSV, lack of in-person staff to treat high volumes of patients puts access to care and quality of care at risk. It’s one reason why ambulatory facilities lean into technologies like IVR and RPA. Such tools help route patients after hours and meet regulatory requirements for patient access while easing pressure on overloaded staff.

But at a time when more family members are caring for loved ones with complex care needs or intellectual or developmental disabilities, rising levels of stress associated with these responsibilities can be exacerbated when these caregivers don’t have ready access to medical advice after hours. It’s a scenario that not only has the potential to delay needed care, but also increases costs, such as when frustrated patients head directly to the emergency department for support because the health system’s flawed “technology first” approach made them feel as if the organization wasn’t listening.

Moreover, “patient burnout” — a concept discussed in a recent TIME magazine article — occurs in part when patients don’t feel as though they are getting the personal attention they need during a health care visit. When breakdowns in the patient experience occur, consumers become more likely to put off care.

What many patients want is someone who listens to and respects them —without long waits or technological go-betweens that prolong care.

How nurse triage support can help

Ambulatory settings are ripe for after-hours nurse triage services as a back-end and backup clinical resource.

These models work by ensuring instant availability of a registered nurse when a patient expresses the need for one-to-one support. When the system transfers calls for support, each phone call is answered by a registered nurse who immediately begins using an evidence-based triage approach to care. This removes the delays in care that occur when a call is answered by an administrative assistant. It also ensures people are directed to the right level of care, promptly.

When emergency care is needed, the triage nurse can help prepare the team for the patient’s arrival by providing the information needed to facilitate care.

The value of after-hours nurse triage support extends beyond quality of care and the patient experience. For ambulatory facilities and emergency departments, such support is also a valuable tool for nurse and clinician retention and recruitment. It not only decreases pressure on clinical teams when patient volumes are high, but also is key to helping nurses and providers establish greater work-life balance. In doing so, nurse triage gives provider organizations an edge in building successful, sustainable models for care.

A more personal approach to after-hours care

Research shows it takes 56 seconds, on average, to make a meaningful connection with a patient. In an era of workforce shortages, the question becomes, “Where do human connections provide the most value — and where can technology enable faster access to care?”

It’s true that the need for tools that effectively route patients to the right care at the right time has intensified. However, relying solely on a tech-enabled approach heightens the potential for missed human connections that are critical to care diagnosis and delivery. Exploring resources for live clinical support after hours — whether via phone or virtually — could give ambulatory facilities a basis for improved care, patient experiences and staff satisfaction for the long term.

Dominique Wells, MSN, RN, is chief operating for  Conduit Health Partners.