This page explains exactly how it was built, where the questions come from, what it cannot do, and how it compares to other options at first patient contact. If anything here warrants challenge or improvement, we want to hear from you.
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.
Telephone triage and primary care decision-support protocols developed by Barton D. Schmitt MD and David A. Thompson MD. Widely used in nurse triage lines, after-hours services, and primary care telephonic assessment across the US, UK, Australia and NZ. The structured yes/no question format in MyVaak draws directly from this model of guided clinical history-taking.
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.
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 Joint Commission Journal and Wearn et al. (2007) in the NZ Medical Journal.
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
Rapport (Q0)
Q0
Spoken consent introduction. The clinician presses play; MyVaak speaks a full introduction to the patient in their own language, explains the process, and asks if they agree to proceed.
Clinician tip: Allow the patient to hear the full introduction. Press Next when ready. Consent is recorded in the clinical note.
Consent
A - Airway (Q1-Q2)
Q1
Can you speak normally right now?
Clinician tip: Observe voice quality. Hoarseness or stridor is an airway risk.
Urgent
Q2
Does your throat feel tight or like it is closing?
Clinician tip: YES = potential anaphylaxis or angioedema. Escalate immediately.
Urgent
B - Breathing (Q3-Q6)
Q3
Are you having trouble breathing right now?
Clinician tip: Primary complaint. Note current SpO2 if available.
Urgent
Q5
Do you feel tightness or heaviness in your chest?
Clinician tip: Patients often describe cardiac pain as heaviness, not pain. Do not dismiss.
Clinician tip: Diaphoresis + breathing difficulty + back pain = possible aortic dissection or STEMI.
Urgent
Q10
Are you bleeding anywhere?
Clinician tip: Internal or external. Check skin and clothing for visible bleeding.
Urgent
D - Neurological (Q11-Q14)
Q11
Do you have a severe headache right now?
Clinician tip: Thunderclap headache = rule out subarachnoid haemorrhage urgently.
Urgent
Q14
Can you move both of your arms and legs normally?
Clinician tip: Limb weakness with back pain = possible spinal cord compression. Minimise movement.
Urgent
E - Pain (Q15-Q19)
Q15
Body diagram - patient taps pain location. Multiple zones allowed.
Clinician tip: Recorded as a pain location map in the clinical note.
Map
Q16
Did the pain start suddenly - like something tore or snapped?
Clinician tip: Tearing back pain + diaphoresis = aortic dissection until proven otherwise. EMERGENCY.
Urgent
Q19
Pain scale 0-10. Patient taps their score.
Clinician tip: Elderly patients often underreport pain. A reported 4/10 may clinically present as 6-7/10.
Score
F - Medical History (Q20-Q27)
Q21
Do you have any drug allergies?
Clinician tip: YES = document before any medication administration.
Urgent
Q25
Do you take any regular medication?
Clinician tip: Blood thinners (warfarin, aspirin) critical for bleeding and intervention decisions.
Warn
Q27
Are you currently fasting?
Clinician tip: Cultural note. Fasting is common in many communities. Affects BSL, anaesthesia safety, and medication timing.
Cultural
G - Escape (Q28)
Q28
Is there anything else important the doctor should know?
Clinician tip: If YES: escape modal appears in the patient's language and interpreter is arranged. Assessment is otherwise complete.
Escape
The full assessment contains 29 questions (IDs 0 to 28). Each question is spoken aloud to the patient in their language. The patient nods or taps YES or NO only. Each answer is recorded in the live clinical note with flag status. Q15 is a body-map interaction. Q18 is a timeline selector. Q19 is a 0-10 pain scale. Q28 is the escape question — if the patient indicates YES, a reassurance message appears in their language and the clinician arranges an interpreter. No reading ability is required from the patient.
What MyVaak can and cannot do
Capability
Status
Notes for clinicians
Structured triage history
Yes
29 questions in ABCDE + Schmitt-Thompson order, 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.
Urgent flag escalation
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
Zero
All session data is held in browser sessionStorage only. Nothing is transmitted to MyVaak servers. No patient record is created. No Privacy Act exposure. No IT procurement trigger.
Patients with cognitive impairment or severe distress
Use caution
The YES/NO format requires a patient who can hear, attend, and respond consistently. If a patient is severely distressed, cognitively impaired, or unresponsive, MyVaak is not appropriate. Arrange an interpreter or use other clinical communication supports.
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 triage 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.
