Evidence map›Paper›PMID 41187328›Full record

Observational studyJournal of medical Internet research2025

Patient Navigation Behavior in a Symptom-Based Self-Triage Mobile App for Direct-to-Consumer Urgent Care: Retrospective Observational Study.

Tarso Augusto Duenhas Accorsi, Flavio Tocci Moreira, Anderson Aires Eduardo, Renata Albaladejo Morbeck, Karen Francine Köhler, Karine De Amicis Lima, Carlos Henrique Sartorato Pedrotti

Abstract readObservational Study
In one paragraph

Observational study in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Tarso Augusto Duenhas AccorsiTelemedicine Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0002-8023-3466
Flavio Tocci MoreiraTelemedicine Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0001-6574-3866
Anderson Aires EduardoDigital Platform, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0001-8045-8043
Renata Albaladejo MorbeckTelemedicine Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0003-1789-1738
Karen Francine KöhlerTelemedicine Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0002-8348-4623
Karine De Amicis LimaTelemedicine Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0002-9936-2436
Carlos Henrique Sartorato PedrottiTelemedicine Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0002-0634-7086

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatient interaction patterns with self-triage modules in mobile health apps during urgent direct-to-consumer telemedicine consultations remain underexplored, despite their critical role in optimizing virtual care pathways.

objectiveThis study aimed to analyze user navigation behaviors within the screen pathways of a symptom-based self-triage mobile app's algorithm during remote urgent care assessments.

methodsThis observational, retrospective, single-center study analyzed data from users who were aged 18 years and older and who voluntarily sought virtual urgent care through the Einstein Conecta (version 2.0; iOS and Android) at a private Brazilian hospital between May 2022 and December 2023. Patients with incomplete connection records were excluded. User interactions were evaluated based on the number of distinct triage flows accessed per session, the number of screens viewed per flow, the frequency of returns to previous screens, and the time spent within the self-triage module. Descriptive statistical methods were applied for analysis.

resultsData from 62,006 unique users with a mean age of 36.51 (SD 10.53) years, of whom 54.65% (33,889/62,006) were female, were analyzed. They initiated 194,976 self-triage flows. We found that 36.89% (22,875/62,006) of users completed 1 flow per session; 22.15% (13,734/62,006) users accessed 2 flows; and 27.93% (17,317/62,006) users accessed ≥4 flows (maximum 63 flows). Users receiving an initial emergency department referral recommendation were more likely to initiate subsequent flows than those recommended for virtual assessment. Returning to a previous screen was infrequent (used by 5277/62,006, 8% of users). The average time spent in the first flow was 70.95 (SD 65.26) seconds, with an average of 9.51 (SD 12.84) seconds per screen.

conclusionsIn this cohort, most users explored alternative pathways beyond the initial self-triage recommendation, particularly when directed to the emergency department, while rarely backtracking within a flow. These findings underscore the need to refine self-triage mechanisms in telemedicine to better align with observed user navigation behaviors and preferences.

Indexed as

Ambulatory CareMobile ApplicationsPatient NavigationTriageAdultBrazilFemaleHumansMaleMiddle AgedRetrospective StudiesTelemedicinedigital healthhuman-computer interactionmHealthmobile appsmobile healthpatient navigationself-triagesymptom checkertelemedicineurgent careuser behavior

Identifiers

PMID41187328
PMCPMC12627970

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.