Concordance between 8-1-1 HealthLink BC Emergency iDoctor-in-assistance (HEiDi) virtual physician advice and subsequent health service utilization for callers to a nurse-managed provincial health information telephone service

Table 2 Operational definitions of VP advice and corresponding concordance criteria

VP Advice	Concordance Criteria
Go to ED Now	The caller has a recorded ED visit within 48 h of the HEiDi call and did not have a recorded hospitalization or FP encounter before the ED visit
Seek FP care now^a	The caller has a recorded FP encounter within seven days of the HEiDi call and did not have a recorded hospitalization or ED visit before the FP encounter
Schedule FP appointment^a	The caller has a recorded FP encounter within seven days of the HEiDi call and did not have a recorded hospitalization or ED visit before the FP encounter
Self-Manage^b	The caller has no recorded ED visits, hospitalizations, or FP encounters within seven days of the HEiDi call

^aIn conversations with VPs, they indicated that “seek FP care now” was considered more urgent than “schedule FP appointment” but noted that time to access FPs varies. A consensus existed that the appointment should be as soon as possible in the former scenario, and ideally within a week for the latter. Given potential access issues that may affect a plurality of patients, we included both dispositions with a one-week timeframe to assess if concordance patterns demonstrate a similar perception of urgency based on subsequent service use
^bNote the final category advises that service use is unnecessary, and so “time-to-concordance” is inverted as “time-to-discordance.”

ISSN: 1472-6963