Telephone triage and advice lines enhance healthcare efficiency by directing patients to appropriate care levels, reducing emergency department visits, and optimizing resource allocation. This paper examines their effectiveness, cost-saving benefits, and technological advancements, including artificial intelligence, in improving patient outcomes while alleviating pressure on overburdened healthcare systems worldwide.
Healthcare systems across the United States and around the world have increasingly adopted telephone triage and advice lines as a means of directing patients to the most appropriate level of care. These services, staffed by trained nurses or medical professionals, help assess symptoms, provide medical guidance, and determine whether a patient requires emergency care, an urgent care visit, or self-care at home (Morse, Ostberg, Jones, & Chan, 2020). Countries like the United Kingdom, Canada, and Australia have implemented similar models.
Telephone triage systems can improve healthcare efficiency, reduce costs, and lead to better patient outcomes. However, these systems are not without challenges. Issues such as misdiagnosis or accessibility barriers decrease the effectiveness of telephone triage systems to meet patient needs. Ever-evolving technology and artificial intelligence play a crucial role in addressing these challenges and improving triage accuracy, ultimately alleviating strain on emergency services and healthcare providers.
Telephone triage and advice lines are essential as the U.S. healthcare system faces mounting pressure from an aging population, escalating healthcare costs, and the lingering effects of the COVID-19 pandemic. With nearly 17% of the U.S. population aged 65 or older and healthcare expenditures surpassing $4.3 trillion in 2021, the demand for medical services only continues to grow (Centers for Medicare & Medicaid Services, 2022). Emergency departments and primary care providers are experiencing increased patient loads, leading to longer wait times and higher costs. Additionally, the healthcare workforce shortage—exacerbated by provider burnout and retirement—limits the system’s capacity to respond effectively (Henry, 2024).
In this challenging landscape, telephone triage services offer a scalable solution by optimizing healthcare resource allocation and ensuring patients receive appropriate care without unnecessary hospital visits. The NHS 111 service in the UK, for example, has been shown to reduce unnecessary emergency department visits while ensuring timely care for those in need (MacLellan, Turnbull, Prichard, & Pope, 2023; Fernandes, & Ray, 2023). Research has shown that nurse-led triage systems like the UK’s NHS 111 and Health Link in Canada help reduce non-urgent emergency department visits while maintaining patient safety (Jeyaraman, Alder, Copstein, Al-Yousif, Suss, & Zarychanski, 2022).
These services rely on trained professionals and decision-support tools to assess symptoms and guide patients to the correct level of care. Increasingly, artificial intelligence and digital health platforms are being integrated to enhance efficiency and accuracy (Chenais, Lagarde, & Gil-Jardiné, 2023). As healthcare systems continue to struggle with workforce shortages and financial constraints, expanding and improving these services will be crucial to maintaining accessible and efficient healthcare for all.
Telephone triage systems can significantly reduce healthcare costs by decreasing unnecessary emergency department (ED) visits, optimizing primary care utilization, and improving resource allocation. Many patients visit the ER for non-emergency conditions that could be treated in lower-cost settings, such as urgent care clinics or through self-care at home. Studies have shown that up to 30% of ER visits in the U.S. are non-urgent, costing the healthcare system billions annually (Weinick, Burns, & Mehrotra, 2010). By providing real-time assessments and directing patients to the most appropriate level of care, telephone triage can help reduce the financial burden on hospitals and insurers while ensuring that emergency resources remain available for true emergencies (Allen, Cummings, & Hockenberry, 2021).
For instance, a study analyzing over 868,000 cases revealed that the use of telephone triage services was inversely associated with unnecessary ambulance use, suggesting that patients received appropriate care without resorting to emergency services (Katayama, Kitamura, Nakao, Himura, & Deguchi, 2022).
In addition to lowering ED demand, telephone triage services help reduce unnecessary primary care visits. Patients often schedule doctor appointments for minor ailments that can be managed with home care or over-the-counter treatments. Triage nurses and digital decision-support tools can assess symptoms remotely and provide guidance, leading to fewer in-person visits and reducing physician workload (Gellert, G. A., Rasławska-Socha, Marcjasz, Price, Heyduk, Mlodawska, & Orzechowski, 2023). This optimization of healthcare resources also allows providers to focus on more critical cases, improving efficiency and patient outcomes (Ziebart, Kfrerer, Stanley, & Austin, 2023). As technology advances, integrating artificial intelligence into triage systems can further enhance accuracy and scalability, driving even greater cost savings across the healthcare system (Thethi, 2024; Alemede, 2025).
Telephone triage services have demonstrated significant improvements in patient health outcomes by facilitating timely medical guidance and appropriate care decisions. A recent study focusing on patients with cerebrovascular diseases found that those who utilized telephone triage services had higher rates of discharge to home by day 21 of hospitalization compared to those who directly called for an ambulance, indicating enhanced recovery trajectories (Deguchi, Katayama, Himura, Nishimura, & Nakagawa, 2023).
Additionally, nurse-led telephone triage systems, especially those utilizing computerized decision support systems (CDSS), have been shown to perform better than general practitioners in certain health-related assessments (Graversen, Christensen, & Pedersen, 2020). This approach resulted in lower levels of clinically relevant undertriage, thereby enhancing patient safety and outcomes.
Telephone triage services continue to prove their efficacy in improving patient health outcomes by ensuring timely, appropriate, and efficient medical care (Napi, Zaidan, Zaidan, Albahri, Alsalem, & Albahri, 2019).
A nurse-led telephone advice line plays a significant role in improving patient education and empowerment by offering accessible, timely, and personalized health information. Patients can call from the comfort of their homes and receive evidence-based guidance tailored to their symptoms or concerns (Karimi, et al, 2021). This immediate access allows for enhanced understanding of their condition, appropriate self-care strategies, as well as clarity on when to seek further care, promoting autonomy and confidence in managing health. Studies have shown that patients who use nurse triage lines report improved knowledge of their conditions and greater satisfaction with self-management support (Sezgin & Bektas, 2024). This model fosters a shift from passive receipt of care to active participation, aligning with broader goals of patient-centered healthcare.
Moreover, telephone advice lines enhance the overall patient experience by offering convenience, reducing anxiety, and building trust in the healthcare system. Many patients appreciate the ability to speak with a knowledgeable healthcare professional without the time, cost, and stress associated with in-person visits. This can be especially beneficial for individuals in rural areas or those with mobility challenges. Research indicates that patients who use nurse advice lines often report high levels of satisfaction with their care, citing feelings of reassurance, improved understanding, and appreciation for compassionate communication from nurses.
In a 2017 qualitative study, Kaminsky and colleagues conducted interviews with patients who had used telephone advice services. They found that patients highly valued the emotional support and professional communication provided by nurses. Participants described feeling reassured and more confident in managing their health after the call. The study highlighted the importance of the nurse’s tone, active listening, and ability to explain medical issues clearly—factors that significantly contributed to a positive experience and overall satisfaction. Telephone triage services not only address immediate clinical concerns but also help patients feel heard and supported, contributing to a more positive and holistic healthcare experience.
The growing adoption of telephone triage and advice lines across global healthcare systems highlights their vital role in optimizing resource allocation, reducing costs, and improving patient outcomes. As research has shown, these services effectively decrease unnecessary emergency department visits, prevent avoidable hospital admissions, and ensure that patients receive the right level of care in a timely manner (Salisbury, Chalder, Scott, Pope, & Moore, 2002; Blank, Coster, O’Cathain, Knowles, Tosh, & Turner, 2012). All of this adds up to a more efficient healthcare industry better equipped to improve patient outcomes. With increasing healthcare demands due to an aging population, workforce shortages, and rising costs, telephone triage provides a scalable and effective solution that enhances access to medical guidance while alleviating pressure on overburdened healthcare facilities.
Additionally, these services promote continuity of care by helping patients navigate the healthcare system, adhere to care plans, and follow up with the appropriate provider. They also enable early detection of serious conditions, particularly in vulnerable or rural populations who may delay seeking care. In this way, telephone triage not only supports the immediate redistribution of clinical workload but also contributes to long-term improvements in public health and chronic disease management. The integration of nurse-led triage into primary and urgent care models reflects a proactive approach to healthcare delivery, positioning it as a critical component of modern, patient-centered systems.
Moreover, advancements in artificial intelligence and digital decision-support tools continue to refine triage accuracy, further strengthening the reliability of these services. These technologies assist nurses by providing evidence-based algorithms and real-time analytics to guide clinical decisions, ensuring that patients are directed to the most appropriate level of care with greater precision. Countries like the United Kingdom and Canada have successfully demonstrated the effectiveness of such systems, reinforcing their potential for broader implementation in the United States and beyond (Taylor, Chmura, Hinson, Steinhart, & Sangal, 2025). In the U.K., the NHS 111 service has become a cornerstone of urgent care, offering both digital and telephone-based triage to manage high patient volumes while maintaining quality care. Similarly, Canada’s HealthLink system and Los Angeles’s Health Nurse advice line have been instrumental in supporting underserved and rural communities, helping reduce disparities in access to care.
By embracing telephone triage as a core component of modern healthcare delivery, systems can improve efficiency, patient safety, and overall health outcomes. These services also support continuity of care by seamlessly integrating with electronic health records and allowing for appropriate follow-up and referrals. In an era where healthcare systems must do more with fewer resources, telephone triage lines stand as a practical and forward-thinking solution, cementing their role in the future of healthcare. Their adaptability, cost-effectiveness, and patient-centered focus make them indispensable in the evolving landscape of digital and community health services.
In my years as a nurse and healthcare leader, I’ve learned that sometimes the most powerful care starts with a simple conversation. I’ve spoken with patients who were scared, uncertain, or just needed someone to listen—and that voice on the other end of the phone made all the difference. Telephone triage isn’t just about directing traffic in a busy system; it’s about meeting people where they are, offering guidance, comfort, and timely care. As we face growing challenges in healthcare, these personal connections—powered by both compassion and technology—are more important than ever.
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Dr. Seleem R. Choudhury, DNP, MBA, RN, CEN, FAEN, is a seasoned healthcare executive and clinician with over 30 years of experience. He currently serves as a senior hospital leader at Adventist HealthCare and is dedicated to advancing population health, patient-centered care, and innovative health system transformation.
