Symptom Checker Agent
Analyzes symptoms to triage risk and guide users toward timely care or claim pathways
Description
Challenge:
Patients often struggle to understand whether their symptoms require immediate attention, a specialist consultation, or basic home care. This uncertainty leads to ER overcrowding, delayed diagnoses, and misrouted cases. Manual triage via call centers or web forms is slow, inconsistent, and lacks personalization. The Symptom Checker Agent solves this by instantly analyzing reported symptoms and suggesting accurate next steps—reducing friction, risk, and unnecessary escalations.
How It Works:
The agent begins by prompting users with structured questions about their symptoms—location, duration, severity, associated factors, and medical history. It leverages a built-in symptom ontology and clinical triage protocols to evaluate potential conditions. The agent cross-references symptoms with predefined risk thresholds and red-flag indicators to determine urgency. Based on this, it either recommends emergency care, directs to a relevant specialist, or provides self-care instructions. Integration with provider directories, appointment systems, and patient records enables real-time handoffs, bookings, and continuity of care. All triage logic is rule-driven, auditable, and continuously improved through feedback loops.
Benefits:
Reduces ER misrouting by 35–50% through symptom-based triage
Delivers triage results in under 60 seconds using guided Q&A
Improves care accessibility and confidence for patients with mild or uncertain symptoms
Standardizes first-level triage using medically vetted protocols
Integrates with provider networks for seamless referral and booking
Captures structured symptom data for downstream clinical workflows
Features
The Symptom Checker Agent transforms how patients navigate early symptoms by combining intelligent questioning, clinical logic, and care routing in a conversational interface. It streamlines first-level assessment, reduces guesswork, and ensures each user is guided toward the right action based on their health context.
Features & Capabilities:
Dynamic Symptom Interview: Conversationally gathers symptom specifics (onset, type, severity, etc.)
Triage Logic Engine: Applies red-flag rules, severity scores, and condition mapping
Specialist Matching: Suggests relevant specialties based on symptom clusters
Urgency Assessment: Differentiates between emergency, outpatient, and home-care situations
Self-Care Guidance: Provides verified tips for mild or common conditions
Referral & Booking Integration: Connects with provider directories for next-step scheduling
Contextual Follow-Up: Recommends diagnostic tests or next check-ins if needed
Multi-language Support: Enables triage in regional languages and voice inputs
Data Logging & Audit Trails: Stores triage outcomes and symptom history for clinical use
Feedback-Driven Improvements: Refines logic based on triage accuracy and outcomes
Eligibility Logic
Decision Logic Flow:
This agent applies a multi-step evaluation to classify the urgency and guide the user appropriately. Each response is assessed against rule-based thresholds and symptom risk scores to ensure medically accurate routing.
Key Logic Pathways Followed:
Initial Symptom Capture → Captures primary complaint and symptom keywords
Red Flag Evaluation → If high-risk indicators (e.g., chest pain, unconsciousness), escalate to emergency
Severity & Duration Assessment → Evaluates symptom intensity and time span to gauge urgency
Associated Symptoms Correlation → Maps combinations to probable conditions (e.g., fever + rash + fatigue)
Medical History Check → Cross-validates with chronic conditions (e.g., diabetes, heart disease) for context
Urgency Determination → Classifies into: Emergency, Specialist, or Self-Care path
Care Path Recommendation → Suggests nearest ER, books appointment, or provides care tips
Follow-Up Triggering → Sets reminders or follow-ups if condition may evolve
Triage Outcome Logging → Stores result for clinician access or future comparison
