Internet zelf triage van influenza achtige ziektes gedurende de H1N1 influenza pandemie in 2009

Ann Emerg Med. 2010 Jun 2. [Epub ahead of print]
Web-Based Self-Triage of Influenza-Like Illness During the 2009 H1N1 Influenza Pandemic.
Kellermann AL, Isakov AP, Parker R, Handrigan MT, Foldy S.
Department of Emergency Medicine; RAND Corporation, Arlington, VA.

Het plotseling ontstaan van de H1N1 influenza in het voorjaar van 2009 zorgde voor een toeloop op de SEHs in New York en andere plaatsen. Een grotere, 2e golf, werd verwacht in het najaar van 2009. Om de mogelijke piek in zorg gebruik te reduceren werd samen met experts in a.o.geneeskunde, verpleging, informatie technologie en public health een algoritme en een zelf triage opgesteld. Het algoritme was voor klinici beschikbaar en de zelf triage via een website voor het publiek beschikbaar.
Mochten de veiligheid en de bruikbaarheid van dit soort sites bevestigd worden dan kan dit een methode zijn om in korte tijd veel epidemiologische gegevens te verzamelen.

The sudden emergence of 2009 H1N1 influenza in the spring of that year sparked a surge in visits to emergency departments in New York City and other communities. A larger, second wave of cases was anticipated the following autumn. To reduce a potential surge of health system utilization without denying needed care, we enlisted the input of experts from medicine, public health, nursing, information technology, and other disciplines to design, test, and deploy clinical algorithms to help minimally trained health care workers and laypeople make informed decisions about care-seeking for influenza-like illness. The product of this collaboration, named Strategy for Off-Site Rapid Triage (SORT) was disseminated in 2 forms. Static algorithms, posted on the Centers for Disease Control and Prevention's Web site, offered guidance to clinicians and telephone call centers on how to manage adults and children with influenza-like illness. In addition, 2 interactive Web sites, http://www.Flu.gov and http://www.H1N1ResponseCenter.com, were created to help adults self-assess their condition and make an informed decision about their need for treatment. Although SORT was anchored in a previously validated clinical decision rule, incorporated the input of expert clinicians, and was subject to small-scale formative evaluations during rapid standup, prospective evaluation is lacking. If its utility and safety are confirmed, SORT may prove to be a useful tool to blunt health system surge and rapidly collect epidemiologic data on future disease outbreaks. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

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