Einsatz von SmED bei Notfallpatient:innen mit geringer Fallschwere in einem universitären Notfallzentrum

The utilization of digital assistance systems within the emergency department (ED) has been proposed in an effort to enhance the triage of low-acuity emergency patients. The SmED (Structured Medical Assessment in Germany), which is employed by the Association of Statutory Health Insurance Physicians, is a promising candidate for the aforementioned objective.

The objective of this study was to assess the suitability of the digital assistance system SmED as a tool for determining the urgency of treatment and the level of care required by low-acuity patients in a university emergency center.

In a prospective observational study, 275 adult ED patients in Manchester Triage System (MTS) categories 3, 4 and 5 (yellow, green and blue) were assessed using SmED for research purposes only. The actual number of inpatient admissions and utilization of specialized emergency resources were compared between the groups discriminated by SmED.

In 70% of cases, SmED recommended treatment in the ED; in 30% of cases, a consultation with a contract physician was recommended. In 79.4% of cases, SmED recommended starting treatment immediately or as soon as possible. In all, 17.9% of patients were recommended treatment within 24 h and 2.7% were recommended to start treatment after 24 h. There was no difference in the admission rate of those patients who would have been directed by SmED to the ED or to a contract physician (56.7% vs. 49.4%, p = 0.28). There was also no difference in resource utilization between the groups.

In our study population, the discriminatory power of the SmED digital assistant was not sufficient to adequately determine the level of care and urgency.