Nurse-1-1 is Creating a Safe Space & Breaking Down Health Disparities

Author: Igor Shumskiy, MD

Why are patients 5 times more likely to discuss their sexual and gender-related health concerns on Nurse-1-1 than on a typical telephone triage call with their doctor’s office? Read on to get my analysis, but more importantly, the reasoning behind why providers, payers, and public health departments should care about this stat. 

First off, what is Nurse-1-1? Nurse-1-1 is the digital doorway to healthcare for the billions of worried patients searching online for information about their health concerns every day. Through personalized, live, text-based nurse chats, patients receive trusted health information so they can make better decisions about their health. 

Sensitive health concerns are common

We often hear, “this is fascinating… what types of health questions do people have???” Turns out that 22% of all health concerns on Nurse-1-1 are related to women’s health, men’s health, teen health, or sexual health. Seems like a reasonable percentage for such common issues, right? 

According to the American College of Physicians – American Society of Internal Medicine report on Telephone Triage, the highest women’s health, men’s health, or sexual health related concern was difficult urination for women, at 2.3%. The next highest was vaginal discharge, at 1.4%. The report doesn’t share further topic breakdowns below 1.4%, however, I’m going to safely assume that the total sum of these types of questions is around 5% of all calls. 

A combined 22% vs 5%. Umm, huh? This means that more than 1 out of every 5 patients on Nurse-1-1 are asking about women’s health, men’s health, or sexual health. While 1 out of every 25 are doing the same with traditional phone triage at their provider’s office. That’s 5 times more on Nurse-1-1 than a typical nurse triage line.😳😳😳

Why this huge difference? And, does it matter?

Well, in my opinion, this matters a whole heck of a lot. Just because traditional primary care nurse hotlines are not getting called about sexual health concerns doesn’t mean these concerns don’t exist. There are many reasons why patients may not want to call and talk to a nurse over the phone about these types of questions. For starters, it can be embarrassing! Usually these are the types of questions that patients feel they must first lie about to the phone scheduler, saying “it’s just a cold” rather than what it truly is, and then having to whisper about it shyly in front of the nurse or doctor.🙈

Furthermore, a lot of people may not even have a trusted provider they feel comfortable enough discussing these types of topics with. This leaves a huge unmet health need with problematic downstream consequences. Miscommunicating the real concern over the phone may lead to delays in care or recommendations for the wrong level of care, potentially leading to higher costs and missed PCP office visits when needed. 

Advantages of text chat for triage

So why is it that people more readily come to Nurse-1-1 with these types of concerns? First, you can safely and privately message our nurses from anywhere! No need to wait until you get home, walk into your bathroom, lock the door, close the window, and make sure that no one is listening before you even think about making the call.🤣😂 Hey, we’ve all been there! Unlike phone calls, no one will know what you are typing even in the most crowded of places (re: 🚃🚎🏢). Also, patients have a sense of anonymity on Nurse-1-1 — we only ask for a first name, an email, an age range, and a gender. As the patient becomes more comfortable with the nurse in the chat, they feel empowered and in control, allowing them to provide more information. 

Probably the biggest reason that breaks down barriers… the way Nurse-1-1 has implemented text messaging. A 2012 study out of the Institute for Social Research at the University of Michigan suggested people are more likely to disclose sensitive information via text than they are over the phone. This is right in line with our experience on Nurse-1-1, texting a trusted nurse, on your terms, creates a safe space unlike any other. It doesn’t hurt that our national network of nurses are highly experienced and carefully selected based on their ability to communicate compassionately through live text chat. 

Why should providers and health plans like you care if patients share sensitive concerns associated with sexual and gender-related health on Nurse-1-1? 

How text chat triage benefits population health

If you are a provider, payer, or a mix of the two, chances are your patients’ sexual health concerns are not being met. As a payer, you are risking your patients postponing care and creating higher healthcare costs down the road (think unnecessary ED visits 😕 for difficulty urinating, pregnancy tests, or erectile dysfunction). As a provider, you may be missing crucial patient traffic that is instead visiting your competing locations since they didn’t have the right outlet to ask you about their personal concern. When is the last time you considered the way your patients step into your virtual doors? It might be time to innovate your offering and reach your patients on a more 21st century level. 

If you’re part of a population health management team, whether as a payer, provider, or public health department, then we need to talk! This discrepancy above clearly shows Nurse-1-1 can have large scale impact on a public health level potentially never seen before. We are already serving thousands of patients across the country who are turning to us for their sensitive questions! Let’s find a way to work together and narrow crucial health disparities by building a network patients never have to feel embarrassed about contacting! 

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