On Development and Evaluation of Prototype Mobile Decision Support for Hospital Triage

Abstract

Ambiguous triage scenarios in hospital emergency departments are often difficult to assess without decision support. Subjective assessments of such scenarios can either lead to under-triaging or over-triaging for which true conditions of patients are often not addressed within the required time. In this paper, we propose a decision support model that can guide a clinician when identifying the urgency of medical intervention when patient presents with ambiguous triage case. Our model is a heuristic approach that selects the best triage category, identifies corresponding discriminating attribute of the patient, and allows clinician to attach a level of confidence in the decision. We implemented this model as a mobile decision support system, called iTriage. Results of an initial evaluation of iTriage using fourteen paper-based adult triage scenarios showed that our model produced robust decisions for urgent scenarios. For non-urgent scenarios, the proposed model provided guidance especially when the scenarios were ambiguously stated.