Enhancing Pre-Hospital Triage at the Primary Care Level: The ERTRIAGE Approach for Greece

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:

  1. Lionis, C. et al. (2018). Primary care in Greece: looking ahead. European Journal of General Practice.

  2. WHO. (2021). Strengthening emergency care systems.

  3. OECD. (2019). Health at a Glance: Europe – Greece Country Profile.

  4. ERTRIAGE Consortium Whitepaper (2024, unpublished prototype evaluation data).

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