How MyVaak works: the questions, the rules and the limits

Everything a clinician or PHO needs to judge MyVaak: where the questions come from, all 29 questions exactly as the tool asks them, how answers are flagged, and when not to use it. The question list below is generated from the live question file, so it always matches what patients hear. If anything here warrants challenge, tell us.

Where the questions come from

ABCDE Assessment Framework

A structured, systematic approach to clinical triage used across emergency medicine, primary care, and pre-hospital settings. Assesses Airway, Breathing, Circulation, Disability (neurological), and Exposure (pain, examination). The sequence is standard training in NZ general practice and emergency nursing.

Resuscitation Council UK - ABCDE Approach

Structured Telephone Triage Principles

MyVaak's yes/no question format draws on established principles of structured telephone and nurse triage protocols — widely used in nurse triage lines, after-hours services, and primary care telephonic assessment across the US, UK, Australia and NZ — adapted for a patient-facing, multilingual audio format. MyVaak is not affiliated with, and does not claim to reproduce, any specific licensed telephone triage product.

HDC Code of Rights - Right 5 | Plain Language Act

The Health and Disability Commissioner Act 1994 gives every patient in New Zealand the right to effective communication in a form and language they understand. MyVaak's opening spoken consent question (Q0) and its structured yes/no format were designed directly around this obligation. MyVaak also supports the intent of the Plain Language Act 2022, which requires government-funded health services to communicate in a way patients can understand.

HDC - Code of Health and Disability Services Consumers' Rights
Plain Language Act 2022

Published Research: Language Barriers in Primary Care

The question flags (urgent/warn) and clinical tip text for each question were informed by published primary care literature on missed diagnoses and adverse events in LEP (Limited English Proficiency) patients, including Divi et al. (2007) in the International Journal for Quality in Health Care and Flores et al. (2003, 2012) on interpreter errors.

Divi et al. (2007) - International Journal for Quality in Health Care 19(2):60-67

MyVaak does not claim clinical validation or endorsement by any of these organisations. These sources describe the published frameworks from which the question set was structured. The question set has not been through a formal clinical trial. That is stated plainly here and in our disclaimer.

How the 29 questions are structured

Consent

You are safe. The doctor is here to help you. MyVaak will ask questions in your language. Please listen and nod YES or NO. Do you understand and agree to continue?

Clinician tip: Speak this before Begin Assessment. Clinician taps YES if patient nods agreement.

Introduction

Rapport

Hello. My name is MyVaak. I am here to help the doctor understand you. I will speak in your language. Please listen and nod YES or NO to each question.

Clinician tip: Introduction. Allow patient to hear fully. Press Next when ready.

Introduction

A: Airway

Can you speak normally right now?

Clinician tip: Observe voice quality simultaneously. Hoarseness or stridor = airway risk regardless of answer.

Review first if NO

Does your throat feel tight, swollen, or blocked?

Clinician tip: YES = potential anaphylaxis or angioedema. Escalate immediately. Check for rash, hives.

Review first if YES

B: Breathing

Are you having difficulty breathing right now?

Clinician tip: Note SpO2 if available. Breathing difficulty = escalate for prompt clinical review.

Review first if YES

Is your breathing getting worse right now?

Clinician tip: Getting worse = higher acuity than stable difficulty. Critical differentiator.

Review first if YES

Do you feel tightness or heaviness in your chest?

Clinician tip: Patients often describe cardiac pain as heaviness, not pain. Do not dismiss.

Notable if YES

Does that tightness spread to your arm, shoulder, jaw, or back?

Clinician tip: YES = strong cardiac red flag. Follow your chest pain protocol; radiation of pain is a warning sign.

Review first if YES

C: Circulation

Are you sweating without reason, cold or clammy sweat?

Clinician tip: Cold sweat + chest pain + back pain = aortic dissection or STEMI until proven otherwise.

Review first if YES

Is your heart beating very fast or unevenly?

Clinician tip: Palpitations + breathing difficulty = rule out PE or AF. Check pulse rate and rhythm.

Notable if YES

Q10

Do you feel faint or like you might pass out?

Clinician tip: Pre-syncope with chest pain = high cardiac risk. Check BP both arms if aortic dissection suspected.

Notable if YES

Q11

Is there any bleeding anywhere on your body?

Clinician tip: Internal or external. Inspect skin and clothing for visible bleeding.

Review first if YES

D: Neurological

Q12

Do you have a sudden severe headache, the worst of your life?

Clinician tip: Thunderclap = worst of life, sudden onset. Rule out subarachnoid haemorrhage urgently.

Review first if YES

Q13

Can you move both your arms and both your legs?

Clinician tip: Inability to move limbs + back pain = spinal cord compression. Do not move patient.

Review first if NO

Q14

Do you have numbness or tingling in your face, arms, or legs?

Clinician tip: Unilateral = stroke/TIA risk. Bilateral hands = hyperventilation. Either warrants investigation.

Notable if YES

Q15

Is your vision blurred or are you seeing double?

Clinician tip: Visual change + headache + hypertension = possible hypertensive emergency. Review urgently.

Notable if YES

E: Pain Location

Q16

Please point to where your pain or discomfort is.

Clinician tip: Patient points to diagram. Tap zones to record. Multiple zones allowed.

Body map

E: Pain Character

Q17

Did the pain start suddenly like a tearing or ripping sensation?

Clinician tip: Sudden tearing back pain + diaphoresis = aortic dissection until proven. EMERGENCY.

Review first if YES

Q18

Does the pain travel down one or both legs?

Clinician tip: One leg = disc/nerve root. Both legs = cauda equina. Ask about bladder/bowel control.

Notable if YES

E: Timeline

Q19

When did this start?

Clinician tip: Sudden onset is more concerning than gradual. Record time of onset.

Timeline

E: Pain Score

Q20

Pain score 0 to 10. Please tap the number.

Clinician tip: Elderly and South Asian patients often underreport. A stated 4/10 may present clinically as 6-7/10.

0-10 scale

F: Medical History

Q21

Are you allergic to any medicine?

Clinician tip: ALWAYS ask before any medication. Document and alert team.

Review first if YES

Q22

Do you have diabetes?

Clinician tip: South Asian patients: 5-6x higher T2D risk. Check BSL. Diabetic neuropathy masks pain presentation.

Notable if YES

Q23

Do you have a known heart condition or high blood pressure?

Clinician tip: Prior MI, valve disease, arrhythmia, hypertension: all affect treatment pathway.

Notable if YES

Q24

Do you take regular medication every day?

Clinician tip: Blood thinners (warfarin, aspirin, dabigatran) critical for bleeding and intervention decisions.

Notable if YES

Q25

Are you pregnant? (asked only if relevant)

Clinician tip: Ask only if relevant (e.g. female patient of reproductive age). Tap 🔊 to ask, or NEXT to skip.

Notable if YES

G: Cultural

Q26

Are you fasting today?

Clinician tip: Fasting is common across all South Asian and Pacific communities. Affects BSL, anaesthesia safety, medication timing.

Notable if YES

G: Comprehension

Q27

Do you understand that the doctor is here to help you?

Clinician tip: Confirms the patient is oriented and understands care is being provided. NO = consider distress, confusion or a language mismatch.

Notable if NO

G: Escape

Q28

Is there anything else important the doctor should know?

Clinician tip: If YES: escape modal shown with icon grid. Patient points to concern.

Recorded

29 questions (Q0 to Q28), identical in every language. Q0 is the spoken introduction; the time the patient agrees to continue is recorded. Q16 is a body map, Q19 a timeline and Q20 a 0-10 pain scale. "Review first" and "Notable" answers are grouped at the top of the note so the clinician sees them straight away - MyVaak does not diagnose, score or decide priority. If the patient answers YES to Q28, they can point to what they need (for example medication, their child, feeling scared) and that choice is written into the note. The block letters follow the ABCDE sequence loosely: pain, history and cultural questions are grouped after it. This is an ABCDE-informed question set, not a formal ABCDE or triage-scale assessment.

What MyVaak can and cannot do

Capability	Status	Notes for clinicians
Structured first-contact history	Yes	29 questions based on ABCDE principles and elements of established triage protocols, spoken in the patient's language, producing a formatted clinical note. Same sequence every session.
Spoken consent in patient's language	Yes	Q0 is a spoken introduction and consent question. Patient response is recorded in the clinical note. Addresses HDC Right 5 documentation at first contact.
Highlights answers to review first	Yes	Clinician-facing flags (red/amber) appear in real time for urgent and warning responses. Clinical interpretation remains entirely with the clinician.
Two-way conversation	No	MyVaak is a structured one-way questionnaire. It speaks; the patient nods or taps. It cannot handle open-ended patient responses, clarification requests, or spontaneous clinical dialogue.
Clinical diagnosis or treatment advice	No	MyVaak produces a structured history. All clinical decisions are made by the clinician. MyVaak has no diagnostic logic or treatment recommendations.
Replacement for a qualified interpreter	No	MyVaak is a structured first-contact tool. Where a qualified interpreter is required - for complex consultation, informed consent for procedures, or mental health assessment - one should be arranged. MyVaak supports the gap until that interpreter is available.
Patient data storage	On device only	Patient names, dates of birth, answers and notes stay in the browser and can be cleared with one tap (they also clear after 10 idle minutes). The server keeps an anonymous usage count per practice: language, number of flagged answers, pain score and time. See the Privacy Policy.
Patients with cognitive impairment or severe distress	Use caution	The YES/NO format needs a patient who can hear, attend and respond consistently. In aged care and dementia, use it only with a carer or family member present to support the patient, and treat answers with caution. If the patient is severely distressed or unresponsive, MyVaak is not appropriate.

Section 5

When not to use MyVaak

Immediate life-threatening emergency

If the patient is in cardiac arrest, is not breathing, or requires immediate resuscitation - call 111. MyVaak is a triage aid for first contact, not a resuscitation tool.

Mental health crisis or acute psychiatric presentation

A structured yes/no assessment tool is not appropriate for mental health assessment. If the patient may be in crisis, arrange a qualified interpreter and use appropriate mental health pathways.

Informed consent for procedures

MyVaak is not a substitute for a qualified medical interpreter when obtaining informed consent for procedures, surgery, or complex treatment. A conversational exchange is required in those contexts.

Patients unable to attend or respond

If the patient is unresponsive, severely distressed, cognitively impaired, or cannot reliably nod or tap YES/NO, MyVaak is not appropriate. Assess by clinical observation and other means.

Paediatric patients (under 10)

The question set is designed for adult patients. Younger children may not be able to reliably respond to the yes/no format. A parent or guardian should be involved in these cases.

Complex ongoing history

MyVaak covers 29 structured questions focused on acute presentation. It is not designed for full past medical history, social history, complex medication reviews, or ongoing chronic disease management conversations.

An open invitation to clinicians

If you use MyVaak, review it and find something that should change - please let us know

Review the question set If a question is clinically ambiguous, in the wrong order, or missing something important for a particular language group or presentation type - we want to know. You can request the full JSON question file by emailing us.

Suggest a language or community If your practice serves a community whose language is not yet available, we prioritise based on real clinical need. Tell us the language, the approximate patient volume, and any community contacts who might assist with translation review.

Propose a pilot or evaluation If you or your PHO are interested in a structured evaluation - tracking use, flagging rates, or clinical utility - we will support that. No formal process required to start a conversation.

We read every message. If you are a GP, practice nurse, PHO clinical lead, or health network manager, your feedback will directly shape the next version of this tool.