Route patient messages, listed symptoms to a nurse first

Fields

• Sender as recorded by the portal (patient or proxy)
• Message, with its subject

Questions

1. Which pool should handle this patient message? Choice

   Read the message. Choose the pool for its main request. When it asks for several things, choose the pool for the part a clinician must read, in this order: a symptom or health problem, then a medication question, then a question about a test result. Otherwise choose the pool for the first request in the message.

   • Symptom or health problem Describes a new, ongoing or worsening symptom or health problem, even in passing.
   • Medication question Asks about side effects, how to take a medicine, or whether to stop, start or change one, with no new symptom described.
   • Test result question Asks what a result from a test already done means, or when it will come.
   • Prescription refill Asks to renew or resend a prescription the patient already takes, with no question about the medicine.
   • Scheduling Asks to book, move or cancel an appointment.
   • Referral status Asks about a referral to another clinic or specialist already made.
   • Forms and records Asks for a letter, work note, disability or school form, or a copy of records or results to share with someone.
   • Billing and insurance Asks about a bill, a payment, insurance coverage or an authorization.
   • No action needed A thank you, an acknowledgement or a reply that asks for nothing.

2. Does the message describe a symptom on the clinics' same-day list? Yes / No

   Read the message and the same-day symptom list in the context. Does the patient describe any symptom on the list, however casually or in their own words, even if they call it nothing? This puts the message in front of a nurse first; it is not a judgment of how urgent the patient's condition is. Yes: The message describes at least one symptom on the list. No: The message describes no symptom on the list.

3. Does the message mention thoughts of suicide or self-harm, or wanting to be dead? Yes / No

   Read the message. Does it mention thoughts of suicide or self-harm, or wanting to be dead or not wake up, even indirectly or about the past? Yes: The message mentions any of these. No: The message mentions none of these.

4. Does any part of the message need a nurse, doctor or pharmacist to read it? Yes / No

   Read the message. Does any part of it need a clinician: a symptom or health problem, a question about a medicine or a dose, or a question about what a result means? Yes: At least one part needs a clinician. No: Every part can be handled by non-clinical staff, such as booking, refills with no question, forms or billing.

5. Does the patient say they have run out of a medicine or have only a few doses left? Yes / No

   Read the message. Does the patient say they have run out of a medicine, have only a few doses left, or will run out soon? Yes: The patient says any of these. No: The patient asks for a refill without saying they are out or nearly out, or asks for no refill.

6. Does the message show it was written by someone other than the patient? Yes / No

   Read the message and the sender_type field. Does the text show it was written by someone other than the patient, such as a parent, partner, adult child or carer, whatever the portal account says? Code checks whether proxy access is on file. Yes: The message is written by someone other than the patient. No: The message reads as written by the patient.

7. Does the message ask for an interpreter or another communication or access need? Yes / No

   Read the message. Does it ask for an interpreter, large print, a phone call instead of messages, help for someone with hearing or sight loss, or another access or communication need? Writing in another language, or in imperfect English, does not count on its own. Yes: The message asks for at least one access or communication need. No: The message asks for none.

8. Does the patient say they have contacted the clinic before about this same matter? Yes / No

   Count an earlier message, call, visit or reference number about the same matter, however the patient puts it ("this is the third time I have asked"). Do not count earlier messages in this same thread, or earlier contacts about other matters. Yes: The patient says they contacted the clinic about this matter before. No: The patient mentions no earlier contact about this matter.

9. Does the message ask for more than one separate thing? Yes / No

   Read the message. Does it ask for, or raise, more than one separate thing that different staff may need to handle, such as a refill and a symptom, or a form and an appointment? Yes: The message raises at least two separate things. No: The message raises one thing, or several points about the same thing.

10. Does the message express dissatisfaction with the clinic's care or service? Yes / No

    Read the message. Does the patient express dissatisfaction, in any words, with the care, the staff, waiting times or anything the clinic did or failed to do? A person decides whether to log it as a complaint or grievance. A plain statement that they are asking again, with no complaint, does not count. Yes: The message expresses dissatisfaction with the clinic's care or service. No: The message expresses none.

Lens columns

pool, pool_probability, possible_same_day_symptom, possible_same_day_symptom_probability, self_harm_language, self_harm_language_probability, needs_clinician, needs_clinician_probability, out_of_medication, out_of_medication_probability, written_by_proxy, written_by_proxy_probability, access_need, access_need_probability, repeat_contact, repeat_contact_probability, several_requests, several_requests_probability, dissatisfaction_expressed, dissatisfaction_expressed_probability