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These authors acknowledge that very few clinical calls occurred during the study period; most calls were made by the research assistant to collect quality of life and anxiety scores [ 28].
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In this case, obvious lung sliding was not apparent, but the final clinical call was 'no true sliding seen but comet-tails and lung pulse - designated No PTX,' suggesting a possible error in interpretation rather than remote imaging accuracy.
It may also be the case that a more cautious approach to decision-making is required when using non-clinical rather than clinical call takers, or they may have less leeway than clinicians to override advice recommended by the software, although research suggests they operate in a similar way to clinical call takers (20).
There was no evidence that users were concerned about non-clinical call takers.
Calls to NHS 111 are answered and assessed by trained non-clinical call handlers using the NHS Pathways assessment system.
A key feature of NHS 111 is the use of non-clinical call handlers to assess calls.
Calls are answered by a non-clinical call handler and assessed by a nurse either immediately or with a later call back.
A unique feature is the use of non-clinical call takers who triage calls with computerized decision support and have access to clinical advisors when necessary.
In 1998 a parallel telephone service for out-of-hours advice called NHS Direct was also established, initially led by nurses but subsequently using non-clinical call handlers.
To our knowledge, the research reported here is the first comparative case study of a CDSS used by clinical and non-clinical call-handlers in different healthcare settings.
The two issues that caused frustration to users may be related to the software used or to the use of non-clinical call takers for triage.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com