After Care Instructions

The Health Navigator After Care Instructions (ACIs) provide health information and care advice for telehealth patients.

Health Navigator ACI content is derived from the care advice in the Schmitt-Thompson telephone triage guidelines. These telephone triage guidelines, authored by Drs. Barton Schmitt and David Thompson, are used by medical call centers and thousands of doctors’ offices across North America. The ACI topics reflect over 20 years of use and testing in nurse advice lines and in consumer symptom checkers.

ACI topics are reviewed on an annual basis by the Health Navigator Medical Review Board. Updates are made, under our clinical governance process, based upon recent medical literature, changes in national guidelines, and feedback from our clinical partners.

Here is an example telemedicine use case scenario:

Joan Johnson is 27 years old and has burning with urination for two days. She calls in and asks to speak with one of the telemedicine doctors.

Dr. Greg Williams calls Joan back right away. He asks her more questions about her symptoms. He determines that Joan does not have any fever, flank pain, or blood in her urine. Joan is not pregnant. Joan does share that about once a year she gets a bladder infection and that this feels exactly the same.

Dr. Williams diagnoses Joan with “Cystitis” and electronically submits a prescription for an antibiotic. Dr. Williams also provides health education over the phone. He covers the most important treatment points and tells Joan that he is going to give her more information on this problem for her to read.

After the telemedicine encounter Joan reads the information on Cystitis that is now available on the telemedicine patient portal.


Example Adult Cystitis After Care Instruction Topic


Here is another use case scenario. This scenario is applicable to medical call center, telemedicine, and primary care doctor’s offices.

Ken Atkinson was recently traveling abroad and is worried that there may have been bed bugs at a hotel where he stayed. He has no rash or other symptoms. He calls seeking information about bed bugs.

The telehealth provider quickly reviews the ACI topic on bed bugs, before speaking with the patient. She uses the ACI topic as a script to answer the patient’s questions.

Bed Bug After Care Instruction Topic


How it works…

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  • Application Programming Interface: Like all Health Navigator clinical content, the ACIs are available through an application programming interface. For example, The GetAfterCareInstruction method returns a single After Care Instruction topic based on the submitted unique ID for the After Care Instruction.
  • Health Literacy: Each ACI topic is written at a fifth to sixth-grade reading level, consistent with health literacy and plain language principles.
  • Topics: There are over 400 adult and pediatric topics. Most of the ACIs topics are symptom-based (such as Cough). Some are diagnosis-based (such as Asthma). These cover the majority of telemedicine symptoms and acute primary care problems. There are 60 first aid topics, each with associated images.


How it improves care…

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Providing After Care Instructions is “Health Information Therapy”. The ACIs deliver important patient education.

After Care Instruction topics can improve patient care and safety by providing:

  • Clinically tested, evidence-based after-care instructions that healthcare providers can use as a script during telehealth encounters.
  • Care advice that patients can easily read and understand.
  • Safety net guidance for when to call back or seek medical attention.

Other potential positive results include:

  • Increased patient and telemedicine provider satisfaction.
  • More consistent care advice, delivered in a more efficient manner.
  • Improved clinical outcomes for patients.
  • Decreased call times and call backs.

After Care Instructions Infographic

Over a third of adults have gone online to try to figure our their diagnosis and over half have used the internet to get health information.