The concept of telephone triage is not new and efforts are directed towards the developments of automated triage systems in medicine. 1 A number of studies both in general practice settings and in major emergency departments have shown the success of these systems. For example, a British study found that telephone triage reduced demand for face-to-face appointments with a general medical practitioner by 39 per cent. 2 A similar study from New Zealand concluded: ‘The rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources.’ 3 Clearly, these studies indicate that when applying a systematic approach, triage is successful on a number of different levels. Expanding on the advantages of triage beyond increasing efficiency of service was the result of a Canadian study that found triage also increased the nurses’ and physicians’ job satisfaction. 4 In this study, a fully computerized guided self-diagnosis system based on a neural network design was designed, prototyped, developed and trialled as a triage system for front line non-clinically trained personnel. MATERIALS AND METHODS Introduction When in need of emergency care, patients either phone or attend the Oral Health Centre of Western Australia (OHCWA). In this trial, reception staff used the electronic triage software to ask patients questions according to their symptoms in order to establish their need for emergency dental care. The electronic triage system was created initially by the development of a diagnostic map and the software was then developed to match the recommendation of the map. Non-clinical staff were trained to use the programme before its implementation. After 18 months the data were collected and analysed for this study. The software was named ‘NightinGale’, after Florence Nightingale, a pioneer in the care of patients. Self-learning software For many years computer software systems were simple serial processes – ‘If this, then do that’. Modern Australian Dental Journal 2006;51:1. 11 Guided self diagnosis: an innovative approach to triage for emergency dental care K Smith,* A Clark,† K Dyson,* E Kruger,* L Lejmanoski,† A Russell,† M Tennant* Abstract Background: The basic model of triage, developed more than 200 years ago by the French, is based on categorization of patient needs and thus the urgency and time required for care. This model in various forms is used in most hospitals throughout the world. Methods: In this study, a fully computerized guided self-diagnosis system (based on a neural network design) was designed, prototyped, developed and trialled by front line non-clinically trained personnel in emergency dentistry. Results: A total of 699 patients were seen as a result of the triage assessment within 14 days of their initial phone call and/or first contact. Patients categorized as requiring care on the day (Category 1) were provided more items of care (50 per cent of all items) and the greatest number of extractions (76 per cent) and endodontic treatments (78 per cent). Other categories were found to require less urgent care. Conclusions: The triage system developed in this study clearly holds significant promise in reducing the impact of emergency dental patients on dental health care systems. However, it is recognized that the system still requires some adjustment to ensure all Category 1 patients are examined before less urgent categories. Key words: Triage, prioritization of dental patients. Abbreviation: Oral Health Centre of Western Australia = OHCWA. (Accepted for publication 21 July 2005.) INTRODUCTION The basic model of triage, developed more than 200 years ago by the French, is based on categorization of patient needs and thus the time and sequence in which patients should receive care. This model in various forms is used in most hospitals throughout the world. It is now a highly refined process but still requires the intervention of trained clinicians in the triage process. *The Centre for Rural and Remote Oral Health, The University of Western Australia. †School of Dentistry/Oral Health Centre of Western Australia, The University of Western Australia. Australian Dental Journal 2006;51:(1):11-15 ADRF RESEARCH REPORT