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Using Video Transmission for Telephone Triage of Children

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ClinicalTrials.gov Identifier: NCT03874520
Recruitment Status : Recruiting
First Posted : March 14, 2019
Last Update Posted : April 12, 2019
Sponsor:
Collaborators:
Copenhagen University Hospital, Hvidovre
Copenhagen University Hospital at Herlev
Rigshospitalet, Denmark
Copenhagen University Hospital Nordsjælland
Copenhagen Academy for Medical Education and Simulation
University of Copenhagen
TrygFonden, Denmark
Amager-Hvidovre Hospital Research Foundation
Information provided by (Responsible Party):
Caroline Gren, Emergency Medical Services, Capital Region, Denmark

Brief Summary:

Background

The medical helpline 1813 in Copenhagen, Denmark handles telephone calls regarding non-life-threatening medical emergencies. Next to 200,000 calls/year concern children and afterwards about 30% are referred to a pediatric urgent care center. However, most of these children have very mild symptoms, which do neither require treatment nor any tests, but merely parental medical guidance.

Initial assessment; triage, of children on the telephone is difficult, especially when the operator does not know the child or the parents, and when it is difficult to describe the symptoms in medical terms. This may result in both too many not-so-sick children getting unnecessarily referred to hospitals, and perhaps also too few more severely sick children sent to the hospital.

Purpose

This project will study if triage of children by videocalls (video triage) provide greater security for parents and health care personnel in the decision that more children can stay at home after medical guidance, thus causing at least 10% fewer visits to a pediatric urgent care center.

Furthermore, the investigators will study if video triage identifies more children with the need of urgent admission to a Department of Pediatrics.

Method

Children aged 6 months to 5 years with symptoms from the respiratory tract will be triaged by either video or telephone by an operator every other day, in order to compare the results between these two similar groups. In cases of video triage, the parent will receive a text message to their smartphone with a video link.

The safety of video triage will be assessed by reviewing the hospital case reports of all patients for contact within the 48 hours after the 1813 call.

Perspectives

Video assessment at call centers may "give eyes to the operators" and revolutionize telephone triage. The study may result in fewer children referred to hospitals, more appropriate use of resources and better experiences for the families.


Condition or disease Intervention/treatment Phase
Telemedicine Triage Respiratory Tract Diseases Pediatrics Other: Video triage Not Applicable

  Show Detailed Description

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 3500 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: The operators at the medical helpline 1813 will triage children meeting the inclusion criteria using video every other day they are at work, and over telephone the other days. Consequently, the operators are always the same, and the only difference between the two groups of patients will be if video triage or telephone triage is performed.
Masking: None (Open Label)
Primary Purpose: Other
Official Title: Using Video Transmission for Optimized Telephone Triage of Children With Respiratory Symptoms at the Medical Helpline 1813 in Copenhagen, Denmark
Actual Study Start Date : February 25, 2019
Estimated Primary Completion Date : August 25, 2019
Estimated Study Completion Date : September 25, 2019

Arm Intervention/treatment
Experimental: Video triage
The sick child will be assessed on video by the operator at the call-center.
Other: Video triage
The operator will offer the parent calling regarding the sick child to assess the child on video, as compared to the current standard; on the telephone.

No Intervention: Telephone triage
The sick child will be assessed solely over the telephone by the operator at the call-center.



Primary Outcome Measures :
  1. Disposition [ Time Frame: disposition is registered by the call operator immediately after the call. ]
    difference between the two arms in the percentage of children that can stay at home the day the parents call 1813, i.e. referral to self-care or GP, compared to the control group.


Secondary Outcome Measures :
  1. Admission [ Time Frame: disposition is registered by the call operator immediately after the call. ]
    difference between the two arms in the percentage of children that are referred to admission at a Department of Pediatrics.

  2. Hospital visits [ Time Frame: the hospital chart of all children are read within 2-8 days after the call. ]
    difference between the two arms in the percentage of how many children that are seen at a hospital within 8 hours or 48 hours after the call to 1813, and does that match the disposition registered by the 1813 nurse? Which diagnosis was given at the hospital?

  3. Safety of disposition choice: percentage of duration of admission [ Time Frame: the hospital charts of all children are read within 2-8 days after the call. ]
    difference between the two arms in the percentage of duration of admission, admission to ICU and mortality.

  4. Nurses' satisfaction: percentage of nurses that were satisfied [ Time Frame: the nurses fill out a questionnaire about the call immediately after each call. ]
    difference between the two arms in the percentage of nurses that were satisfied with the call to a acceptable extent or better in the two groups.

  5. Technical difficulty, nurses [ Time Frame: the nurses fill out a questionnaire about the call immediately after each call. ]
    the number of nurses that found the video call to be technically easy to conduct to a moderate extent or better.

  6. Technical quality of the video call [ Time Frame: the nurses fill out a questionnaire about the call immediately after each call. ]
    the number of nurses that found the sound- and picture quality of the video call as acceptable or better.

  7. Disposition choice [ Time Frame: the nurses fill out a questionnaire about the call immediately after each call. ]
    the percentage of nurses that felt safer about the choice of disposition after video triage compared to after a regular telephone triage, to a acceptable extent or better.

  8. Parents' perception of getting answers to their questions [ Time Frame: the parents are sent a link to an online questionnaire immediately after the call to 1813. ]
    difference between the two arms in the percentage of parents that felt that they got their questions answered during the call to a acceptable extent or better.

  9. Parents' satisfaction about assessment: percentage of parents that felt safe about the assessment [ Time Frame: the parents are sent a link to an online questionnaire immediately after the call to 1813. ]
    difference between the two arms in the percentage of parents that felt safe about the assessment of their children to a acceptable extent or better.

  10. Parents' satisfaction about the plan for the child: percentage of parents that felt safe [ Time Frame: the parents are sent a link to an online questionnaire immediately after the call to 1813. ]
    difference between the two arms in the percentage of parents that felt safe about the plan for their children to a acceptable extent or better

  11. Parents' satisfaction about the call: number of parents in the two arms who were satisfied [ Time Frame: the parents are sent a link to an online questionnaire immediately after the call to 1813. ]
    difference in the number of parents in the two arms who were satisfied with the call to a acceptable extent or better.

  12. Technical difficulty, parents [ Time Frame: the parents are sent a link to an online questionnaire immediately after the call to 1813. ]
    the number of parents that found the video call to be technically easy to conduct to a acceptable extent or better.

  13. Economy [ Time Frame: the number of visits to hospitals in each arm will be studied at the completion of enrolling patients. ]
    how many visits at the pediatric urgent care clinics and at departments of pediatrics, respectively, that could be avoided by using video triage.

  14. Non-participating parents [ Time Frame: these parameters will be studied at the completion of enrollment of patients. ]
    Description of differences in the ages, diagnoses, dispositions between the children whose parents wanted to participate in video triage and those who did not.



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Ages Eligible for Study:   6 Months to 5 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Symptoms presented to the 1813 operator categorized as: coughing/breathing difficulties, cold or suspected influenza.
  • Parents are calling from a smartphone with Apple, Windows or Android operating system.

Exclusion Criteria:

  • The child has already participated.
  • The parent does not call from a Danish telephone number.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03874520


Contacts
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Contact: Caroline Gren, MD +4560813190 ida.caroline.gren.02@regionh.dk
Contact: Dina Cortes, MD, DrMedSci +4523707630 dina.cortes@regionh.dk

Locations
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Denmark
Emergency Medical Services Recruiting
Copenhagen, Denmark
Contact: Caroline Gren, MD    +4560813190    ida.caroline.gren.02@regionh.dk   
Contact: Fredrik Folke, MD, PhD    +4528182978    ff@heart.dk   
Principal Investigator: Caroline Gren, MD         
Sponsors and Collaborators
Emergency Medical Services, Capital Region, Denmark
Copenhagen University Hospital, Hvidovre
Copenhagen University Hospital at Herlev
Rigshospitalet, Denmark
Copenhagen University Hospital Nordsjælland
Copenhagen Academy for Medical Education and Simulation
University of Copenhagen
TrygFonden, Denmark
Amager-Hvidovre Hospital Research Foundation
Investigators
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Study Chair: Dina Cortes, MD, DrMedSci Department of Pediatrics, Copenhagen University Hospital Hvidovre

Publications:
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Responsible Party: Caroline Gren, MD, Emergency Medical Services, Capital Region, Denmark
ClinicalTrials.gov Identifier: NCT03874520     History of Changes
Other Study ID Numbers: Videotriage 1813
First Posted: March 14, 2019    Key Record Dates
Last Update Posted: April 12, 2019
Last Verified: April 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Caroline Gren, Emergency Medical Services, Capital Region, Denmark:
Telemedicine
Triage
Call Centers
Respiratory Tract Diseases
Pediatrics

Additional relevant MeSH terms:
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Respiratory Tract Diseases