Enhancing Pre-Hospital Triage at the Primary Care Level: The ERTRIAGE Approach for Greece
In Greece, tertiary hospitals, particularly in urban centers like Athens and Thessaloniki, remain overburdened by non-urgent cases, many of which could be effectively managed at the primary healthcare level. According to a study by Lionis et al. (2018), the absence of a robust gatekeeping system in Greece leads to high volumes of inappropriate emergency department (ED) visits, straining resources and delaying care for critically ill patients.
ERTRIAGE, a validated, hybrid digital triage and monitoring system, offers an innovative, scalable solution by extending triage capabilities to Primary Healthcare Centers (PHCs), remote clinics, and community health units.
How It Works:
Web-based platform: ERTRIAGE operates via a secure, multilingual web system accessible from remote Points-of-Care, including PHCs and mobile units.
Real-time monitoring: Integration with validated medical devices allows continuous data acquisition (e.g., SpO2, temperature, BP, ECG).
Personalized severity scoring: Using clinically validated protocols and rule-based algorithms, the system provides evidence-based triage decisions.
- Coordination mechanisms: Health professionals can consult, refer, or escalate cases based on real-time prioritization, avoiding unnecessary hospital referrals
Impact on the Greek Health System:
How PHCs can be empowered with ERTRIAGE:
Over 30% reduction in non-urgent ED admissions is achievable (based on comparable deployments in other EU-funded pilots).
Cost savings result from reduced diagnostic redundancy and optimized resource allocation.
Time-to-treatment improves for high-risk patients due to less congestion at hospital EDs.
Cross-unit coordination among rural clinics, ambulatory units (e.g., EKAV), and hospitals becomes seamless.
Policy Alignment:
The approach supports primary care strengthening, a strategic goal under Greece’s National Health System Reform, and aligns with WHO recommendations on community-level emergency care systems.
Scalability & Integration:
The modular and interoperable design of ERTRIAGE allows:
Direct integration with EHR systems
Expansion into telemedicine and disaster response frameworks
Inclusion of climate-sensitive triage protocols for heatstroke, asthma, or vector-borne diseases, making it future-proof
ERTRIAGE represents a transformational tool for Greece’s health system by reinforcing PHCs with triage capacity, optimizing hospital utilization, and delivering cost-effective, patient-centered care. Investing in such digital pre-hospital strategies is not just innovative—it’s essential for resilient, sustainable healthcare in the post-pandemic era.
References:
Lionis, C. et al. (2018). Primary care in Greece: looking ahead. European Journal of General Practice.
WHO. (2021). Strengthening emergency care systems.
OECD. (2019). Health at a Glance: Europe – Greece Country Profile.
ERTRIAGE Consortium Whitepaper (2024, unpublished prototype evaluation data).