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by Yaneer Bar-Yam
Step IV: Accelerate Intake Routing
When patients are routed quickly and smoothly to the right provider, care is improved.

One of the strengths of our current healthcare system is that the critical task of routing patients to appropriate specialists is performed by primary care physicians. They are also often on call to respond to inquiries about urgent care or referral to an emergency room.

How patients are routed to appropriate care is a crucial aspect of running an efficient medical system. As we consider changes to our healthcare system, it is vital to note the importance of accurate and timely routing, to focus resources on keeping this process reliable, and to improve upon it where possible.

Routing is known in medical circles as triage. Unlike the triage in disaster or wartime, triage in a modern medical setting simply refers to the act of directing patients to the appropriate care.

Today, most routing occurs in the primary care physician's office or through the physician's after hours call-in system. This process often works smoothly, with knowledgeable family physicians, internists or pediatricians assessing patients in a timely manner and routing them appropriately. They may treat a patient directly or refer to an appropriate specialist or clinic.

When care is required after-hours and the PCP is not available, patients call a service to reach the doctor on call. Some medical offices provide extended-hour urgent visits. Some practices and insurance agencies also provide 24-hour phone access to medical professionals through a “nurse line.” These call-in services can provide feedback to the patient as to whether he or she should go to the emergency room, or whether their condition can wait.

However, the medical routing system doesn’t always work efficiently.

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