Los Angeles—How useful are online COVID-19 assessment tools in general and in detecting patients who urgently need care?

A new analysis found that the majority of people who were concerned enough about possible COVID-19 symptoms to use an online assessment tool weren’t sick enough to require immediate medical attention.

A report in the Journal of General Internal Medicine points out that, of the more than 275,000 users worldwide of the University of Southern California’s web-based COVID-19 patient self-assessment tool, only 20% reported severe enough symptoms to require urgent medical intervention.
“Among users of our tool with symptoms of COVID-19, 80 percent reported mild symptoms that can likely be managed with simple home self-care,” said lead researchers William Mehring, a first-year medical student at USC’s Keck School of Medicine.

The study team analyzed nearly 300,000 digital self-assessments from the COVID-19 self-assessment tool, finding that 69.6% of users reported symptoms potentially attributable to COVID-19. Of the users reporting symptoms, 80.5% had only mild symptoms that likely could be managed with self-care, the researchers suggest.

Despite lack of data on the users, the authors argue that their results are useful, explaining, “Nevertheless, the widespread use of our tool highlights the willingness of the public to engage with digital health tools and self-assessment in this time of public health crisis. Future research should examine the accuracy and effectiveness of digital self-assessments among those with COVID-19 disease, as well as other uses of such technology, such as for triaging directly into telehealth or testing appointments, offering daily follow-up physical and mental health screening, and digital contact tracing.”

The free tool, available in English and Spanish, was developed in partnership with AltaMed Health Services, the nation’s largest independent federally qualified community health center. AltaMed, which operates nine COVID-19 testing sites throughout Los Angeles County, has been using the tool to help triage patients seeking care for symptoms that may be due to the infection.

“During normal times, there are many barriers to our communities seeking healthcare services,” explained Ilan Shapiro, MD, medical director of health education and wellness at AltaMed. “Digital tools like the patient self-assessment tool, coupled with access to in-person consultations like our testing and evaluation sites, are critical for ensuring patients can receive the care they need now and after the pandemic.”

Using information from the national CDC as a resource, the tool asks users to provide answers to six simple questions about their current situation, including the nature of the user’s symptoms; risk factors for COVID-19 such as advanced age or presence of high-risk chronic medical conditions; and whether they work in a high-risk environment that requires close physical interaction with others. Based on these answers, the tool provides an assessment along with customized recommendations regarding evaluation and treatment, self-care, and infection-prevention practices.

Mr. Mehring suggests COVID-19 assessment tools could be helpful in allowing patients to self-triage, noting, “This could be a way to de-stress the system, which in some areas became quickly overburdened and still is. In the future it could be used as a way to collect data on outbreaks and determine where they are occurring.”
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