Using Nurse Chat for Clinical Advice in Primary Care Pediatrics (Spotlight Poster)

Patients have historically utilized various methods of communication to schedule an appointment, request medication refills, or seek medical advice to determine the necessary level of care. Patients verbalized increased frustration with hold time for a phone agent or message portal response times. Across the nation, health care has shifted to a higher utilization of virtual services as a means of communication and car advice. Extended message response times by medical personnel continue to be impacted by illness surges, message volume fluctuations, or staffing concerns. Chat has become an increasingly popular alternative. With consideration to the aspects of user experience, we determined that “on-the-go” digital communication is preferred and personalized messenger-based experiences are currently ranked 2nd as preferred means of communication.

Objective of the pediatric live chat: Ensure patient needs are met during viral illness surges. Increase access to healthcare services/ decrease unnecessary ED and UC utilization. Offer personalized advice via access to patient electronic health record to achieve high satisfaction.

Description: With assistance from a secure digital patient communication platform, our healthcare system developed a program that provides the community with additional tools, connecting them to a team of highly qualified pediatric registered nurses. The live chat feature accommodates general medical advice, immediate medical triage, and transfer of message to the primary care practice when needed, eliminating back-and-forth messaging via the patient portal.

Outcomes: Patients requiring triage are fully assessed via the chat. Triage protocols are utilized to determine the disposition and appropriate level of care. Depending on the final disposition, the patient is either provided with at-home care advice, scheduled for an appointment with their PCP, referred to urgent care or ED, or set up with a virtual visit via the on-demand platform.

Data: We have received over 20,000 chat requests since inception. Approximately 50% of the chats are triage in nature. Recent expansion with hours of availability being 7 am – 7 pm/7 days per week.

Parent Feedback: “Chat has been helpful for me to have reassurance, troubleshoot symptoms, and determine the next best steps for caring for my child.” “They helped give me guidance on what to observe, when to make a visit/reach back out, and took the time to message me through my patient portal with some helpful information about fevers in infants.” “The real-time messaging, discussion and support helped me stay calm, feel heard, and get immediate advice and guidance.”