Medical emergency triage and patient prioritisation in a telemedicine environment: a systematic review

摘要

Medical institutions face serious problems, such as growing elderly population and lack of doctors. Telemedicine and remote health monitoring system (RHMS) intend to tackle these problems by slightly shortening hospital stays. RHMS reduces the burden on patients with primary care and improves communication among different health units to reduce the burden on emergency departments. Several healthcare studies have attempted to replace hospital visits with RHMS to deliver triage and prioritisation for patients because of considerable advances in wireless information communication and signal-processing technology. The process of medical triage determines the severity of a patient's situation, whilst prioritisation is carried out to provide healthcare services for patients in due course to save their lives. An essential investigation is required to highlight the drawbacks of the current situation of patient triage and prioritisation over telemedicine environment. In this paper, a systematic review of medical emergency triage and patient prioritisation in a telemedicine environment was presented on the basis of two critical directions. Firstly, previous studies on patient triage and prioritisation in such an environment were collected, analysed and categorised. Secondly, many standards and guidelines of triage and different methods and techniques of prioritisation were presented and reviewed in detail. The following results were obtained: (1) The limitations and problems of existing patient triage and prioritisation methods were presented and emphasised. (2) The combination of triage and prioritisation of patients with chronic heart disease was not presented. (3) A framework based on evidence theory and integration of multilayer analytical hierarchy process and technique for order of preference by similarity to ideal solution methods can be used in the future in order to triage chronic heart disease patients into different emergency levels and prioritise many patients to receive emergency and treatment-based services.