PSIAM enables call-takers to collect demographic and insurance information about the person needing medical assistance and to provide information to the call-taker. In the case of an emergency, the software immediately accesses the ProQA software engine and begins the process of emergency medical dispatch. In non-emergent cases, the call-taker accesses the ATRUST Teleguide Algorithm component. PSIAM interfaces to voice and data transfer mechanisms so that the caller is routed to the most appropriately trained call taker (EMD or nurse). Interfaces to external data resources such as postal databases and out-of-hours answering services are managed through TCP/IP interface protocols and engines, as well as CAD systems, email and faxing services. CTI and ANI/ALI software engines are used to manage call queuing where appropriate. Optional software queuing functions can also be used. Intranet interface software is used to manage the XML content of the ProQA and Teleguide systems.
PSIAM is configurable to accept either emergency-only (“first generation” ambulance dispatch) or non-emergency only (“first generation” nurse triage) calls, or to accept both types of calls (Integrated Access Management). In the latter situation, call processing begins when the call-taker selects the ‘new call’ task. This opens a new record in the call database. Each field entry made in the software is date and time stamped (to the second) along with the call-taker ID. The call-taker then begins call processing by asking if the call is an emergency.
Call Processing: Emergencies
If the caller indicates that a medical emergency is present, PSIAM transfers the call to an EMD-capable operator via a message waiting queue. Times for entry and retrieval from the queue are captured in a database. At the EMD-capable call-taking station, PSIAM manages emergency calls in the queue by a first in, first out method. PSIAM then calls the ProQA software engine and subsequently waits for ProQA to return an appropriate indicator.
Call Processing: Non-Emergencies
If the caller indicates that a medical emergency is not present, then PSIAM transfers the call to a nurse. As above, times for entry and retrieval from the queue are captured in a database. PSIAM then selects an appropriate non-emergent call from a queue according to the length of time in the queue and the potential urgency of the chief complaint.
In contrast to the call handling the procedure for emergencies, PSIAM prompts nurses in non-emergent situations to collect caller information prior to the actual clinical interaction. PSIAM can search for a subscriber based on subscriber name, dependent name, telephone number, subscriber ID, birth date, address (postal codes, zip codes or city), Soundex codes, or various combinations of these traits (e.g. Smith and birth date in 1984). The default language of the caller is ascertained by the subscriber data record and then used to either populate the appropriate language protocols and algorithms or to route to appropriate language lines. Should the subscriber not be on file, an option to add a provisional subscriber is used (for subsequent verification by the insurance provider).
Information that is displayed on the subscriber verification/problem screen includes:
* Person’s name (verification/search)
* Provider (verification/provisional assignment)
* Date of birth/age (verification)
* Gender (verification)
* Historical information: allergies, medical history, social behavior, medications.
* Caller name (entry)
* Relationship (entry)
* Callback number (entry)
Following the collection of demographic and insurance verification information, PSIAM then accesses the Teleguide Algorithms and processes the call until an end state is reached.
True Integration
PSIAM includes a patent-pending clinical link that automatically transfers callers between the Teleguide Algorithms and ProQA when appropriate. Thus, the information from callers who are initially managed according to a non-emergent (ATRUST Teleguide Algorithm) call process and who are subsequently found to have a true medical emergency is seamlessly transferred shunted into the appropriate ProQA protocols, and vice-versa. Information passed back through the interface includes the chief complaint, algorithm selected for triage, problem description and dispatch code. By a similar mechanism, dispositions and level of care recommendations can be modified in real time in cases where the caller’s clinical situation seems to be changing.
Closing the Call
After the above-described call process has been completed, there is a brief “post-incident” data collection process in which the following facts are obtained:
* Original Intention
* Actual disposition
* Notes
* Nurse log/acceptance
The physical record of the caller-call taker interaction is stored to disk with routine archiving to permanent media (CD, DVD) on a scheduled basis.