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Telephone triage, expert systems and clinical expertise
Author(s) -
Greatbatch D.,
Hanlon G.,
Goode J.,
O'Cathain A.,
Strangleman T.,
Luff D.
Publication year - 2005
Publication title -
sociology of health and illness
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.146
H-Index - 97
eISSN - 1467-9566
pISSN - 0141-9889
DOI - 10.1111/j.1467-9566.2005.00475.x
Subject(s) - triage , privilege (computing) , service (business) , control (management) , nursing , expert system , medicine , knowledge management , medical education , public relations , computer science , business , medical emergency , computer security , political science , marketing , artificial intelligence
This paper reports on a qualitative study of the use of an expert system developed for the British telephone triage service NHS Direct. This system, known as CAS, is designed to standardise and control the interaction between NHS Direct nurses and callers. The paper shows, however, that in practice the nurses use CAS in a range of ways and, in so doing, privilege their own expertise and deliver an individualised service. The paper concludes by arguing that NHS Direct management's policy of using CAS as a means of standardising service delivery will achieve only limited success due not only to the professional ideology of nursing but also to the fact that rule‐based expert systems capture only part of what ‘experts’ do.