The 116117 help line in Germany: Patient assistance by telephone versus online self-assessment

The digitalization of the German healthcare system offers considerable potential to improve the delivery of care.Digital access pathways to the care system could, among other things, make it easier to reach hard-to-access target groups and mitigate the effects of workforce shortages.Since 2020, the 116117 patient assistance helpline provided by the German Associations of Statutory Health Insurance Physicians (ASHIPs, Kassenärztliche Vereinigungen) has been available by telephone nationwide 24 hours a day, 7 days a week, for people with health-related complaints.For the initial medical assessment, the specially trained healthcare professionals use the software SmED (Structured Initial Medical Assessment in Germany, Strukturierte medizinische Ersteinschätzung in Deutschland) (1, 2).This software is certified as a Class IIb (medium-to high-risk) medical device in line with the EU Medical Device Regulation.Since December 2021, the telephone service has been supplemented by a digital option for self-assessment.The feature referred to as the "online patient navigator" is available via the 116117 patient services website (www.116117.de/de/patienten-navi.php).Here, individuals seeking help can carry out an SmED self-assessment using a chatbot.Based on age, sex, signs of an emergency, acute and chronic medical problems, as well as risk factors, SmED provides recommendations, both by telephone and online, regarding how rapidly individuals seeking help should obtain further medical evaluation and which service to contact (112, an emergency department, or a medical practice).No diagnoses are made.Depending on the SmED result as well as the region, day, and time, patients have the option to immediately book a physician appointment via an appointment portal (by telephone in all cases; online in currently 14 ASHIPs).The aim of the study was to analyze the use of online self-assessment compared with telephone-based initial assessment.The user-friendliness of the online self-assessment was also examined.