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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 28-October-2005, Vol 118 No 1224

[full text] [PDF]

Healthline: do primary care doctors agree with the advice?
Ian St George, Matthew Cullen, Michelle Branney

Abstract


Aims
To assess agreement between the advice to symptomatic callers to Healthline, and that advised by primary care doctors given the same clinical information, and thus to assess the safety of Healthline advice.

Methods
Ninety records of symptomatic calls to Healthline were examined by three primary care specialists, blinded to the actual advice given. They independently recorded what they would have advised, and their advice was compared with that actually given by the Healthline nurse guided by Care Enhance Call Centre software.

Results
Variation among the three doctors was greater than that between the median doctor and Healthline. In 82% of cases, the median doctor triaged to an endpoint close to (or lower than) Healthline. In all but one of the remainder, at least one doctor thought there was no risk to the patient (i.e. in 99% of cases). Review of that case indicated nurse error and the guideline itself was judged to be safe.

Conclusion
New Zealand primary care specialists regarded the Care Enhance Call Centre decision support software used by Healthline as clinically safe.

     
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