The advance of communication technology has changed medical practice. The concept of medical telemedicine centers receiving, assessing and managing calls from patients or their carers on a 24 hour, 7 days a week basis is spreading in the US as well as in European countries. Usually specially trained nurses using dedicated decision support software provide the service. One aspect is the so-called triage, i.e. the decision on urgency and optimal treatment path of a stated medical problem, which has the potential to contain overall treatment costs.

Despite proliferation of these services, little is known about the quality of the services provided.

In October 2000 the first 24-hour medical telemedicine centre staffed by medical doctors started operating in Switzerland. The aims of this study are to assess the quality of service provided by doctors using decision support software and to determine potential predictors of incorrect triage.

Inclusion Criteria:

• Adult
• Insured with HMO Basel
• Patient of HMO practise Sternengasse
• First call to Medgate for a given medical problem
• Call is a telephone triage
• Informed consent

Exclusion Criteria:

• none

Regular HMO patients