How governments are using AI to manage patient demand: Care navigation and digital triage

This article breaks down three of the most common questions governments and health systems are asking about AI-driven care navigation, triage, and demand management. Plus, we've got insights spanning government policy, clinical practice, and commercial strategy from three of Infermedica's leaders.

The global healthcare conundrum 

The move to digital health is not one of simply jumping on the AI bandwagon. It’s addressing a known challenge: Health systems around the world are under immense pressure, and forecasts suggest this will only worsen over time.

Aging populations

On one side, populations are aging fast. The share of people aged 65 and over across OECD countries is projected to rise to 26.7% by 2050. This is a shift that matters because chronic disease risk rises sharply with age, and in the US alone, 90% of the $4.5 trillion spent on healthcare in 2022 went toward treating people with chronic physical and mental health conditions.

Healthcare worker shortage

Compounding the pressure from an aging population is the fact that the workforce needed to treat them is lacking in numbers.

The WHO projects a global shortfall of 11 million healthcare workers by 2030. An ageing health workforce — in the US 33% of nurses will retire by 2030 and, in Germany, over 36% of GPs are older than 60 — is part of a trend that promises to exacerbate an already fragile situation.

Patients feel the strain

The result is visible worldwide in numbers that directly affect patients and their ability to access care.

In England, despite being at its lowest point in nearly three years, the NHS waiting list still stood at approximately 7.3 million in early 2026, while A&E attendances hit a record 2.4 million in a single month in June 2026.

In Canada, the share of people reporting difficult or no access to a family doctor rose from 40% in 2015 to 50% in 2025.

These are just a few examples, yet the numbers tell similar stories all around the world.

Data for a deeper problem

There's data to suggest that these problems cannot be solved by manpower alone. One report from Germany shows that in 2024 the number of practicing physicians rose by 2% to 437,000. Yet, the same report goes on to state that, ‘It is assumed that this growth will not be sufficient to counteract the demographic change in the population and the approaching retirement of numerous doctors’. In other words, hiring new doctors will not be enough on its own.

Governments and health systems are increasingly looking elsewhere for relief — and one of the fastest-growing answers is AI-powered digital health tools that help manage where, when, and how patients enter the system in the first place.

How are governments using AI for healthcare navigation and triage services?

Governments and national health systems are deploying AI-powered triage and care navigation tools to help guide patients to the right level of care. Installed in apps or on government health websites, these tools are designed to be the very first point of contact when a person is feeling unwell—instead of calling a GP, going to an emergency department, or joining a waiting list.

AI tools assess patients' needs and direct them to the right setting: self-care advice, a pharmacy, a GP appointment, community services, urgent care, and other care settings.

We're already seeing this in action in the United Kingdom as NHS England announced a rollout of AI triage in the NHS App. An early trial saw a 29% drop in patients queuing on the phone for an appointment, with the tool set to reach all NHS App users by 2028.

How are governments and health systems using digital health tools to manage patient demand?

Governments and public health systems are using digital health tools to shift some of the demand away from the busiest parts of the system and spread patients across more appropriate settings. By implementing digital tools such as symptom checkers and AI triage, health systems can offer more diverse access points and scale to population needs. 

The use of digital tools is reshaping patient demand. Patients are directed to the most appropriate level of care for their needs, e.g. self-care, teleconsultation, or mental health support, while the most urgent cases are still identified and prioritized. For health systems facing rising patient volumes and limited clinical capacity, this kind of demand management is as important as adding staff or beds.

This isn't just theoretical. There’s a growing body of published data to support digital tools’ efficiency in helping to manage patient demand.

A study published in NEJM AI found that Infermedica improves health system efficiency without compromising patient safety, with 55% of consumers who initially intended to attend the emergency department diverted to lower-acuity settings.

And in one study of a nurse call center triage service, 20% of symptom assessments took place outside of regular physician operating hours. Of these out-of-hours encounters, virtual triage directed 48% of these cases to lower-acuity care settings than they had originally planned to visit, many of whom might otherwise have queued for the next available appointment or ended up in an emergency setting.

What digital health tools do public health systems use for symptom assessment and patient triage?

Public health systems primarily rely on two categories of digital tools: self-service symptom checkers that patients use directly via an app or website and AI-powered clinical decision support for call handlers during live calls.

In practice, these tools work by asking a patient a series of adaptive questions about their symptoms, medical history, and risk factors, then generating a recommendation and connecting them to the most appropriate care setting. 

The same underlying triage engine is often used in more than one channel at once: a person might interact with it directly online, while a nurse uses the same system as decision support during a phone call. This flexibility is part of why these tools have been adopted at national scale by public health systems, rather than staying confined to a single point of contact.

Healthdirect Australia is a good example of this in practice. Healthdirect is a government-funded virtual health service that provides free access to health advice and information via a website, app, and 24/7 telephone nurse advice helpline. Healthdirect uses the same underlying triage technology across two channels: as a self-service online symptom checker and as clinical decision support for registered nurses on its helpline. The service supports 26 million Australians, illustrating how a single triage engine can scale from individual self-checks to a full national helpline without needing separate systems for each.

Healthdirect Australia has seen remarkable results since adopting digital tools on its frontline. In a peer-reviewed study of 1.55 million patient encounters, the impact of virtual triage on demand management, patient navigation, and the appropriate use of resources is clear.

• Reduced emergency department intent: Patients intending to visit the ED dropped from 36.7% to 24.6% following virtual triage.

• Near-elimination of patient uncertainty: 99.6% reduction in patients who were unsure about the level or what kind of care they needed.

• Increased use of virtual and underutilized care pathways: Virtual emergency department services increased from 0.6% to 8.8%, indicating greater adoption of appropriate digital and non-traditional care options.

• High engagement of Aboriginal and Indigenous patients: 5.8% of participants were of the Aboriginal or Torres Strait Islander race or ethnicity, which comprised a larger percentage of the sample than their contribution to the national population (3.2%). The study suggests that virtual triage has the potential to ameliorate longstanding race-related care access and service delivery inequities.

• High usage amongst parents: 31.8% of users were parents searching for healthcare assistance for their children, showing how virtual triage solutions can be an important tool for busy parents needing healthcare guidance for their kids.

The bigger picture

Patient demand management, care navigation, and triage aren't three separate trends. They're three facets of the same shift where adjustment to either one has major benefits for patients, clinicians, and the health system as a whole.

Governments are moving toward a model where AI helps patients reach the right care, at the right time, by expanding access through digital channels to guide patients to the most appropriate care setting for their needs.

For health systems facing aging populations, stretched workforces, and finite budgets, AI-powered solutions offer a way to address all of these major challenges. This isn't a future consideration. It's already happening—from the NHS in England to Healthdirect in Australia, and many countries in between—with results that are already compelling.

The question for most governments now isn't whether to adopt AI-powered triage and navigation tools, but how to get the best out of these technologies and how to scale them responsibly.

If you're exploring how AI-powered triage and care navigation could work for your health system, explore Infermedica's solutions for governments and public health systems →

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