Video triage by emergency medical service secondary triage clinicians in Victoria, Australia

BackgroundUse of video triage in emergency medical dispatch centres is novel. We describe the impact of a video triage trial on call outcomes, triage accuracy and recontact with the emergency medical service in Victoria, Australia.MethodsA retrospective observational study of consecutive low to medium-acuity emergency ambulance calls undergoing secondary triage between 27/11/2023 and 17/03/2024. Propensity matching was performed to match video triage patients with traditional telephone triage patients.ResultsVideo triage patients were younger than telephone triage patients (49.1 vs. 59.2 years), and more frequently called in-hours (49.5% vs. 39.0%) for injuries or wounds (24.8% vs. 9.1%). Propensity matching yielded 1036 matched pairs. In the matched population, video triage was associated with reduced odds of emergency ambulance dispatch (odds ratio [OR] = 0.621 [95% confidence interval [CI] 0.521,0.741]) and increased odds of referral to alternate health services (OR = 1.287 [95%CI 1.032,1.605]). The odds of recontact within 24 hours among patients referred to alternate services were halved after video triage (OR = 0.514 [95%CI 0.320,0.826]). The technology was associated with increased alignment between dispatch priority and patient acuity (OR = 1.356 [95%CI 1.019,1.804]), and a reduction in over-triage (OR = 0.695 [95%CI 0.520,0.929]). Although, the overall secondary triage duration was longer when video triage was used (22 vs. 15 minutes, <i>P</i> < 0.001), there was no difference in time to ambulance dispatch for time-critical patients.ConclusionVideo triage by secondary triage clinicians was associated with fewer emergency ambulance dispatches, more referrals to alternate services, fewer recontacts and improved triage accuracy. Expansion of the technology to primary triage warrants exploration.