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Telehealth Training Manuals and Guidelines -- trusted by medical professionals since 1985


Universal Telephone Triage Guideline


Current CDSS does not appear to significantly reduce error in telephone triage (Wheeler et al, 2015).  This failure might be related to an overly deterministic approach fostered by an algorithmic design.   Download the Comparison of Algorithmic vs. Pattern Recognition Approach to Guideline Design for a detailed description of both approaches.

Telephone triage work involves the extraordinary challenge of making safe decisions under conditions of uncertainty and urgency.   Thus, electronic guidelines must both reduce human error (through built-in fail-safe measures) and support metacognition (knowing when & how to use certain strategies to solve a problem).

Ms. Wheeler’s approach to telephone triage has used a 5-Level approach from the beginning.  Wheeler’s 1995 Adult and Pediatric guidelines pre-dated current 5-Tier Triage Strategies developed by ESI (2018) and Manchester Triage Group (2017).

Ms. Wheeler seeks to collaborate with software and EMR (EHR) companies to refine their existing Clinical Decision Support Systems. Please call 415 453 8382 to arrange for a demonstration of the prototype.

Built-in Standards-based Fail Safes will Reduce Root Causes of Error and Failures of:

  • Assessment Checklists (Gawande)
  • Communication/Documentation
  • Continuity
  • Informed consent
  • Human Error Avoidance

Integrated System 

  1. Universal Guideline (Standard, Procedure)
  2. EMR (Paper trail, track/trend)
  3. Training Manuals
  4. Standards (Procedure/Policies)
    1. Built in to Guideline, EMR, Training Materials

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