How a decentralized, volunteer-powered helpline transformed access to COVID-19 testing, information, and care diversion for uninsured and underinsured patients.
Overview
In the early months of the COVID-19 pandemic, charitable clinics across the U.S. faced overwhelming call volumes, leaving uninsured and underinsured patients without timely access to testing and accurate information. Working in real time to develop a best-fit solution, BSRI partnered with Sostento, Inc. and three large charitable clinics in Georgia, Texas, and Minnesota to design and evaluate HelplineSOS, a decentralized telephonic triage system. Funded by the National Science Foundation’s Rapid Response program, the initiative standardized volunteer-driven callbacks, streamlined patient navigation, and maintained continuity of care while minimizing in-person exposure.
Our Approach
As the evaluation partner, BSRI designed the evaluation framework for HelplineSOS, monitored implementation, and measured efficiency gains, patient reach, and changes in clinic capacity. We provided real-time feedback to Sostento, the operational lead, and to participating clinics so findings could inform decisions throughout the project.
Sostento coordinated with clinic leadership to integrate HelplineSOS into existing workflows and deploy a decentralized volunteer network. The model relied on standardized training and protocols aligned with CDC guidance, a real-time outcomes dashboard for quality assurance and process improvement, and engagement strategies such as block scheduling, feedback loops, and regular check-ins to sustain volunteer participation. This structure created resilient telephonic infrastructure during the height of the pandemic, enabling clinics to respond effectively to surging patient demand.
Impact
HelplineSOS demonstrated how a volunteer-powered, technology-enabled triage system can rapidly expand healthcare access in low-resource settings without increasing staff. Across the research period, participating clinics tripled their call response capacity, managing an average of 713 patient calls per week—more than 7,000 calls during the study and over 40,000 calls since launch. This surge in capacity came with an 85% callback contact rate and a 75% completion rate, both exceeding industry benchmarks, while maintaining a same-day callback guarantee.
The model extended reach beyond clinic patients, with 75% of callbacks serving community members who might not otherwise access timely care. By integrating Spanish-language support and streamlined referral pathways, the system improved equity in access and diverted symptomatic patients away from urgent care and emergency departments to telehealth or safe testing sites thereby reducing the strain on urgent care and emergency departments.
These outcomes illustrate HelplineSOS’s potential as a scalable infrastructure for public health response and ongoing care coordination. The model’s use of accessible technology, standardized protocols, and an engaged volunteer network provides a blueprint for expanding healthcare navigation services, enhancing surge capacity, and supporting real-time public health surveillance in future crises.
What We Learned
Through our evaluation, BSRI identified key factors that make volunteer-powered telephonic triage both scalable and sustainable, with applications well beyond the COVID-19 era:
- Volunteer efficiency can scale quickly. With structure and training, volunteers averaged 12 callbacks per week, contributing about two hours each without burnout.
- Accessible technology levels the field. The model did not require clinical licensure, enabling rapid onboarding and equitable participation.
- Human connection matters. Volunteers and patients valued slower-paced, empathetic conversations without the pressure of a constantly ringing phone.
- Crisis infrastructure has long-term value. Clinics saw ongoing potential for the helpline in managing chronic care coordination and patient navigation beyond COVID-19.
Team Behind the Work
Lead Organizations
- Sostento, Inc.
- Good Samaritan (GA), Open Cities (MN), and Mercy (TX) charitable clinics
- Behavioral Science Research Institute (BSRI)
Funding Partner
- National Science Foundation – Rapid Response Research (RAPID) program
