Reducing unnecessary urgent care visits
Médis, the most recognized health insurer in Portugal, and Infermedica have established a partnership which resulted in the implementation of Infermedica’s Call Center Triage tool in Médis’ Clinical Contact Center. This partnership has allowed Médis to enhance their clients’ and nurses’ experience, and streamline operational processes, while Infermedica was able to improve the triage and recommendation capabilities of their Call Center Triage solution. The implementation has improved the interview process and prevented unnecessary urgent care visits and appointments.
Private healthcare provider
Médis’ mission is to provide clients with an outstanding experience that is relevant to their needs through its Personal Health Service®. The company offers an integrated system of medical facilities, including medical care, telemedicine, and online consultations, having successfully built a strong and integrated ecosystem.
As a result of the partnership between Médis and Infermedica, a new solution was developed and implemented in the Médis Clinical Contact Center. Powered by AI and machine learning, this solution helps Médis’ nurses throughout the triage flow, from symptom reports to clinical recommendations.
The client calls the Médis Clinical Contact Center for an evaluation of their symptoms. The system automatically identifies the client’s ID, gender and age.
The client provides information about their symptoms, risk factors, and chronic conditions, and the nurse enters this information into the AI system.
In the case of extremely severe symptoms (“red flags”), the triage process immediately stops and the nurse must inform the client that they may require immediate emergency help.
Based on the information input, Infermedica’s AI-powered engine dynamically selects tailored questions for the nurse to ask the client.
As a result of the interview, the client is able to make an informed decision based on the recommendation given by the nurse.
Note: The information in the images shown is not real; it’s a mere simulation with random information.
Comparison with clients’ initial intention before calling Médis Clinical Contact Center shows that the tool has prevented unnecessary urgent visits and increased the frequency of the self-care option. Additionally, the implementation of this new clinical triage solution has led to an improved experience for Médis nurses and clients.
Percentage of cases in which the client’s initial intention was to seek urgent care vs percentage of urgent care recommendations.
Percentage of cases in which the client’s initial intention was self-care vs percentage of self-care recommendations.
Number of triage processes completed with the use of Infermedica Call Center Triage.
Percentage of all reported clients’ symptoms being covered by the tool.
One of the main advantages, compared to the previous solution, is that the Infermedica platform is dynamic. This means the system has a clinical update every 3 months, which makes it more and more accurate and improved with usage. Also, the solution has a solid clinical knowledge base, which is developed and constantly updated by Infermedica’s team of medical doctors.
The project required the implementation team to adapt its activities and product to unforeseen events and circumstances. One of the necessities was to create a separate branch of services, the triage of pediatric cases, which was successfully created in partnership. Additionally, the solution had to be adapted so that it could be integrated with Médis’ current IT systems.
Also, we were positively surprised noticing how the team understands the specific issues of working with a big corporate, which means that sometimes deadlines have to be adapted and project’s scope is modified unexpectedly.
We are pleased with the results of introducing the Call Center Triage at Médis' Clinical Contact Center - preventing unnecessary emergency visits, improving the user experience of nurses and supporting the work of call center coordinators.