We thank Patrick Potter for taking the time to comment on telehealth in his recent letter.1 He may not realize that the goal of triage is not to make a diagnosis. As his anecdote illustrates, it is foolhardy to attempt to “make the diagnosis over the phone.” Rather, the goal of telephone nursing assessment is symptom triage. Clearly, it is not diagnostic certainty that allows for sorting to be accomplished, and this cannot be done by rote or scripted automatons. Trained and experienced nurses, who listen reflectively, aided by tools that prevent gaps in information gathering and documentation, have been providing this function for at least 15 years.2 No suit against a triage provider has successfully shown an inability to sort out the emergently ill. This safety record stands in the highly litigious atmosphere of our US neighbours, where millions of triage calls are conducted annually (Raul Seballos, Cleveland Clinic, Cleveland: personal communication, 2002). The originators of this type of triage were pediatricians, seeking relief from the onerous after-hours phone calls that plague most acute care physicians.
Peter O'Hanley Medical Director Clinidata Moncton, NB Susan MacLean Medical Director Telehealth Ontario Toronto, Ont. Maurice St-Martin Medical Director Telehealth Ontario Sudbury, Ont.
References
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